MICHAEL LEWIS BLACK

SANTA ANA, CA
NPI1780620955
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2085N0700X Radiology, Neuroradiology
(Licence: CA  G55416)
Additional Taxonomies2085B0100X Radiology, Body Imaging
(Licence: CA  G55416)
2085R0202X Radiology, Diagnostic Radiology
(Licence: CA  G55416)
2085U0001X Radiology, Diagnostic Ultrasound
(Licence: CA  G55416)
Enumeration Date2006-06-22
Last Update Date2014-05-08
Business Address
-- MICHAEL LEWIS BLACK M.D.
1100 N TUSTIN AVE
SANTA ANA, CA 92705-3509
Phone number: 714-835-6055
Mailing Address
-- MICHAEL LEWIS BLACK M.D.
6 HIDALGO
IRVINE, CA 92620-1854
Phone number: 714-835-3709