Healthcare Provider Details

I. General information

NPI: 1538704119
Provider Name (Legal Business Name): SCRC MEDICAL GROUP PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2019
Last Update Date: 11/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 N ROXBURY DR STE 500
BEVERLY HILLS CA
90210-4226
US

IV. Provider business mailing address

450 N ROXBURY DR STE 750
BEVERLY HILLS CA
90210-4226
US

V. Phone/Fax

Practice location:
  • Phone: 310-277-2393
  • Fax:
Mailing address:
  • Phone: 310-277-2393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. KYLE FRANCIS
Title or Position: CEO
Credential:
Phone: 310-277-2393