Organization
PLBC MEDICAL GROUP, INC
Active
Organization
PLBC MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KRISTI FUNK MD (PRESIDENT)
(310) 273-8002
Entity
Organization
Contact information
Practice address
8900 WILSHIRE BLVD, SUITE 300, BEVERLY HILLS, CA 90211
(310) 273-8002
(310) 273-8608
Mailing address
8900 WILSHIRE BLVD, SUITE 300, BEVERLY HILLS, CA 90211
(310) 273-8002
(310) 273-8608
Taxonomy
Speciality
Code
Description
License number
State
170100000X
Ph.D. Medical Genetics
—
—
2471M2300X
Mammography Radiologic Technologist
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
261QR0206X
Mammography Clinic/Center
—
—
363LW0102X
Women's Health Nurse Practitioner
—
—
Other
Enumeration date
08/28/2016
Last updated
08/28/2016
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