MR. VADIM I BEDEROV (NPI# 1659681278) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1659681278 |
Entity Type | Individual |
Full Name | MR. VADIM I BEDEROV |
Credential | P.A. |
Practice Address |
795 El Camino Real Palo Alto CA 94301 |
Mailing Address |
325 Distel Cir Los Altos CA 94022-1408 |
Practice Telephone | 6508532951 |
Mailing Telephone | 6508536608 |
Enumeration Date | 2010-10-16 |
Last Update Date | 2020-05-28 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA22795 | CA | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
795 EL CAMINO REAL |
City | PALO ALTO |
State | CA |
Zip Code | 94301 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346248085 | Wendy Levine | Occupational Therapist | 795 El Camino Real, Palo Alto, CA 94301-2302 | 2005-07-07 |
1932706637 | Ashley Powell | Occupational Therapist | 795 El Camino Real, Palo Alto, CA 94301-2302 | 2020-10-06 |
1568069268 | Madeline Manion | Physical Therapist | 795 El Camino Real, Palo Alto, CA 94301-2302 | 2020-10-06 |
1245847565 | Sandrine Nicolet | Physical Therapist | 795 El Camino Real, Palo Alto, CA 94301-2302 | 2020-09-30 |
1164058731 | Shannon Tram Anh Trinh | Pharmacist | 795 El Camino Real, Palo Alto, CA 94301-2302 | 2020-03-16 |
1205460243 | Caitlin Schubmehl | Nurse Practitioner | 795 El Camino Real, Palo Alto, CA 94301-2302 | 2020-02-28 |
1518502350 | Odiri Maku | Nurse Practitioner | 795 El Camino Real, Palo Alto, CA 94301-2302 | 2019-11-15 |
1841847167 | Rachel Zatkin Kizuka | Registered Nurse | 795 El Camino Real, Palo Alto, CA 94301-2302 | 2019-08-21 |
1497300974 | Christopher Duane Asplund | Physical Therapist | 795 El Camino Real, Palo Alto, CA 94301-2302 | 2019-08-02 |
1033673991 | Jingyun Yao | Speech-Language Pathologist | 795 El Camino Real, Palo Alto, CA 94301 | 2019-01-24 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1184256430 | Stephen H Smith | Marriage & Family Therapist | 636 Middlefield Road, Palo Alto, CA 94301 | 2020-02-05 |
1992367072 | Thomas Mccavitt | Interpreter | Feinberg Medical Clinic, 825 El Camino Real, Palo Alto, CA 94301 | 2019-06-28 |
1598321861 | Priyanka Kim Wali, M.d., P.C. | Psychiatry & Neurology | 470 Ramona Street, Palo Alto, CA 94301 | 2019-05-13 |
1942716196 | Nancy L Wong | Dermatology | 970 Palo Alto Ave, Palo Alto, CA 94301 | 2017-12-26 |
1245751221 | Kurbo Health | Health Educator | 640 Waverley St, Palo Alto, CA 94301 | 2017-06-29 |
1023559085 | Michelle Di Montagna | Acupuncturist | 200 California Avenue, Suite 100, Palo Alto, CA 94301 | 2017-03-10 |
1265978175 | April Rowe Holman | Psychologist | 667 Lytton Ave. Ste. 5, Palo Alto, CA 94301 | 2017-01-17 |
1174975056 | Jeanmarie Barry Cahill | Marriage & Family Therapist | 555 Middle Field Road, Suite 103 B, Palo Alto, CA 94301 | 2016-07-05 |
1700247897 | Marie A. Di Pasquale | Allergy & Immunology | 705 Lincoln Avenue, Palo Alto, CA 94301 | 2016-03-16 |
1750780128 | Ronces Reyes-pugay | Nurse Practitioner | 795 Elcamino Real, Level 3 Lee Building, Palo Alto, CA 94301 | 2014-08-21 |
Find all providers in zip 94301 |
Taxonomy Code | 363AS0400X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Surgical Technologist |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1366497331 | Gunars Bite | Physician Assistant | 3821 Ross Rd, Palo Alto, CA 94303-4523 | 2006-05-24 |
1689275059 | Colin Elie | Physician Assistant | 725 Welch Rd, Palo Alto, CA 94304-1601 | 2020-11-03 |
1164939930 | Edward Andy Nguyen | Physician Assistant | 750 Welch Rd Ste 319, Palo Alto, CA 94304-1510 | 2018-01-03 |
1285147454 | Eric Hong | Physician Assistant | 725 Welch Rd, Palo Alto, CA 94304-1601 | 2017-11-09 |
1942659610 | Geovanna Suarez | Physician Assistant | 780 Welch Rd, Palo Alto, CA 94304-1516 | 2016-06-03 |
1306282496 | Sunaina Ganesh | Physician Assistant | 795 El Camino Real, Palo Alto, CA 94301-2302 | 2013-05-15 |
1043560972 | Julia Constance Bertozzi | Physician Assistant | 795 El Camino Real, Palo Alto, CA 94301-2302 | 2012-09-18 |
1760765846 | Chad Pope | Physician Assistant | 750 Welch Rd, Suite 319, Palo Alto, CA 94304-1507 | 2011-09-24 |
1760783286 | Katie Felix | Physician Assistant | 725 Welch Rd, Palo Alto, CA 94304-1601 | 2010-11-15 |
1871828533 | Russell James Miles | Physician Assistant | 875 Blake Wilbur Drive, Palo Alto, CA 94305 | 2009-10-13 |
Find all providers in PALO ALTO |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.