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Individual

JASON LINVILLE BLACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NURSE PRACTITIONER

Contact information

Practice address
1000 W CARSON ST, TORRANCE, CA 90502-2059
(424) 306-6595
Mailing address
2250 NORCO DR, NORCO, CA 92860-1118
(310) 497-2777

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95029238
CA

Other

Enumeration date
04/04/2024
Last updated
04/04/2024
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