Black, Michael Lewis

Black, Michael Lewis is an individual health care provider with primary practice located at 1100 N Tustin Ave , Santa Ana CA 92705-3509. He recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Body Imaging, Allopathic & Osteopathic Physicians / Neuroradiology, Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Diagnostic Ultrasound. Allopathic & Osteopathic Physicians / Neuroradiology is his primary health care specialty. Black, Michael Lewis can be contacted via phone (714) 835-6055.

Contact Information

Primary practice address
1100 N Tustin Ave Santa Ana CA 92705-3509
Phone: (714) 835-6055
Fax: (714) 835-3287
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Body Imaging 2085B0100X G55416 California
Allopathic & Osteopathic Physicians / Neuroradiology 2085N0700X G55416 California
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X G55416 California
Allopathic & Osteopathic Physicians / Diagnostic Ultrasound 2085U0001X G55416 California

Profile Details

NPI number 1780620955
LBN Legal business name Black, Michael Lewis
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2006
Last updated May 8th, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780620955 NPPES
California MEDICAID 00G554160

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