Provider Demographics
NPI:1700110699
Name:BEDI, SUE H (DC)
Entity Type:Individual
Prefix:DR
First Name:SUE
Middle Name:H
Last Name:BEDI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2205 BRIDGEPOINTE PKWY APT 217
Mailing Address - Street 2:
Mailing Address - City:FOSTER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94404-5016
Mailing Address - Country:US
Mailing Address - Phone:571-528-6888
Mailing Address - Fax:
Practice Address - Street 1:4675 STEVENS CREEK BLVD STE 121
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051-6763
Practice Address - Country:US
Practice Address - Phone:571-528-6888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-24
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36614111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor