Individual
JAMIE Z BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2929 HEALTH CENTER DR, SAN DIEGO, CA 92123-2762
(858) 939-6540
Mailing address
1684 E ORANGEWOOD ST, GILBERT, AZ 85296-2628
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
63413
CA
Other
Enumeration date
11/09/2011
Last updated
07/03/2024
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