Healthcare Provider Details

I. General information

NPI: 1679257323
Provider Name (Legal Business Name): BIANCA MARIE CULHANE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2023
Last Update Date: 02/25/2026
Certification Date: 02/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 N SAN VICENTE BLVD STE 200
BEVERLY HILLS CA
90211-2325
US

IV. Provider business mailing address

113 N SAN VICENTE BLVD STE 200
BEVERLY HILLS CA
90211-2325
US

V. Phone/Fax

Practice location:
  • Phone: 310-954-1008
  • Fax:
Mailing address:
  • Phone: 310-954-1008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: