Individual
MARLON DEAN BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2320 BATH STREET SUITE 208, SANTA BARBARA, CA 93105-5322
(805) 682-7984
(805) 569-2964
Mailing address
DEPT LA 21613, PASADENA, CA 91185-1613
(949) 263-8620
(949) 263-1639
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A84822
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A848220
BS
CA
05
—
00A848220
—
CA
Enumeration date
05/04/2007
Last updated
07/07/2022
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