| Doctor Name: | MICHAEL LEWIS BLACK |
| NPI Number: | 1780620955 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | G55416 |
| Business Practice Address: | 1100 N Tustin Ave Santa Ana, CA - 927053509 |
| Business Phone Number: | 7148356055 |
| Business Fax Number: | 7148353287 |
| Mailing Address: | 6 Hidalgo, IRVINE |
| State: | CA |
| Postal Code: | 926201854 |
| Phone Number: | 7148353709 |
| Fax Number: | 7148353287 |
| NPI Enumeration Date: | 06/22/2006 |
| NPI Last Update Date: | 05/08/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085B0100X |
| License Number: | G55416 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Body Imaging |
| Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |