Individual
FREDERICK COSTON BEDDINGFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 MEDICAL PLAZA, #450, LOS ANGELES, CA 90095
(310) 825-0631
Mailing address
FILE #55737, LOS ANGELES, CA 90074
(310) 825-6911
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A51146
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A511460
MEDICAL PPIN #
CA
Enumeration date
07/08/2006
Last updated
04/01/2011
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