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Individual

MS. RANDI MCALLISTER BLACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
1500 E DUARTE RD, DUARTE, CA 91010
(626) 359-8111
Mailing address
PO BOX 5063, MONROVIA, CA 91017-7163
(626) 775-3200
(626) 775-3271

Taxonomy

Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
PSY11499
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PSY114990
CA
Enumeration date
09/20/2006
Last updated
04/16/2013
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