Provider Demographics
NPI:1679257323
Name:CULHANE, BIANCA MARIE (PA-C)
Entity type:Individual
Prefix:
First Name:BIANCA
Middle Name:MARIE
Last Name:CULHANE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4368 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-2918
Mailing Address - Country:US
Mailing Address - Phone:951-742-7324
Mailing Address - Fax:
Practice Address - Street 1:2001 SANTA MONICA BLVD STE 1260W
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2110
Practice Address - Country:US
Practice Address - Phone:310-829-1711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-13
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant