Individual
DR. JEANETTE MARIE BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9201 W SUNSET BLVD, SUITE 602, LOS ANGELES, CA 90069-3701
(310) 246-0495
(310) 246-0496
Mailing address
2285 CORPORATE CIR, STE 200, HENDERSON, NV 89074-7759
(702) 360-2763
(949) 783-2880
Taxonomy
Speciality
Code
Description
License number
State
207NS0135X
Procedural Dermatology Physician
Primary
A136731
CA
Other
Enumeration date
03/31/2010
Last updated
06/23/2017
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