Individual
PHOEBE HANNAH JOHNSON-BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
757 WESTWOOD PLZ STE 6263, LOS ANGELES, CA 90095-1437
(310) 267-9448
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
Taxonomy
Speciality
Code
Description
License number
State
2084A2900X
Neurocritical Care Physician
Primary
A163477
CA
2084N0400X
Neurology Physician
A163477
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
390200000X
39 STUDENT
CA
Enumeration date
04/23/2018
Last updated
07/18/2022
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