Individual provider · NPI-1

Laura Funkhouser, M.D.

Pediatrics, Neurodevelopmental Disabilities · Loma Linda, CA

NPI number1710067251
StatusActive
Last updated in NPPESJul 8, 2007

Details

NPI
1710067251
Entity type
Individual (NPI-1)
Name
Laura Funkhouser
Credential
M.D.
Sex
Female
Sole proprietor
No
Enumeration date
Oct 17, 2006
Last updated
Jul 8, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2080P0008X Pediatrics, Neurodevelopmental DisabilitiesG70416CAYes

Practice location

11370 Anderson St
Ste.B-100
Loma Linda, CA 92354-3450

Phone 909-558-2848

Mailing address

54701 File Number
Los Angeles, CA 90074-4701

Phone 909-558-3111

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