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1164274833
JASON LINVILLE BLACK
TORRANCE, CA
NPI
1164274833
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: CA 95029238)
Enumeration Date
2024-04-04
Last Update Date
2024-04-04
Business Address
JASON LINVILLE BLACK Nurse Practitioner
1000 W CARSON ST
TORRANCE, CA 90502-2059
Phone number: 424-306-6595
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Mailing Address
JASON LINVILLE BLACK Nurse Practitioner
2250 NORCO DR
NORCO, CA 92860-1118
Phone number: 310-497-2777
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