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Individual

JED ERIC BLACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
401 QUARRY RD, SUITE 3301, STANFORD, CA 94305
(650) 725-5917
Mailing address
1920 PARK BLVD, PALO ALTO, CA 94306-1141
(650) 725-5917
(650) 725-8910

Taxonomy

Speciality
Code
Description
License number
State
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
Primary
G074329
CA

Other

Enumeration date
02/13/2007
Last updated
07/08/2007
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