Individual
DANIEL BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1851 MELANIE CT, SANTA MARIA, CA 93454-5505
(805) 325-0042
Mailing address
14342 TILDEN ST, WESTMINSTER, CA 92683-5139
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA64104
CA
Other
Enumeration date
10/30/2023
Last updated
02/21/2024
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