Individual
MR. ALEXANDER LESLIE BLACK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
31625 HIGHWAY 101 S, SOLEDAD, CA 93960-9529
(831) 678-5500
Mailing address
700 RIVER OAKS DR, PASO ROBLES, CA 93446-6341
(805) 610-5431
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
LCS9337
CA
Other
Enumeration date
05/04/2017
Last updated
05/04/2017
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