Provider Demographics
NPI:1962552703
Name:BENDECK RYDELL, SANDRA ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:ELIZABETH
Last Name:BENDECK RYDELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SANDRA
Other - Middle Name:ELIZABETH
Other - Last Name:BENDECK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:5300 IRON HORSE PKWY
Mailing Address - Street 2:# 371
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-2043
Mailing Address - Country:US
Mailing Address - Phone:646-621-0780
Mailing Address - Fax:
Practice Address - Street 1:5300 IRON HORSE PKWY
Practice Address - Street 2:# 371
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-2043
Practice Address - Country:US
Practice Address - Phone:646-621-0780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA053096207N00000X
CAA80276207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology