Provider Demographics
NPI:1912193111
Name:MCGREGOR, CAROLE BEDROSIAN (RN)
Entity Type:Individual
Prefix:
First Name:CAROLE
Middle Name:BEDROSIAN
Last Name:MCGREGOR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4410 MEADOWBROOK DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94803-2004
Mailing Address - Country:US
Mailing Address - Phone:510-223-7548
Mailing Address - Fax:
Practice Address - Street 1:1000 SAN LEANDRO BLVD
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-1598
Practice Address - Country:US
Practice Address - Phone:510-667-3673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-20
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA267125163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse