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Organization

JAMES JENS BLACK, M.D., INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. VALERIE G. DIAZ (OFFICE MANAGER)
(310) 530-4200
Entity
Organization

Contact information

Practice address
22930 CRENSHAW BLVD STE D, TORRANCE, CA 90505-3048
(310) 530-4200
(310) 530-1562
Mailing address
22930 CRENSHAW BLVD STE D, TORRANCE, CA 90505-3048
(310) 530-4200
(310) 530-1562

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G67618
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G676181
CA
Enumeration date
12/10/2008
Last updated
12/10/2008
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