Individual
MS. DIANE BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.AC.
Contact information
Practice address
506 SANTA MONICA BLVD, SUITE 317, SANTA MONICA, CA 90401-2434
(310) 458-0666
(310) 451-0670
Mailing address
506 SANTA MONICA BLVD, SUITE 317, SANTA MONICA, CA 90401-2434
(310) 458-0666
(310) 451-0670
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC3223
CA
Other
Enumeration date
03/09/2007
Last updated
07/08/2007
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