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DR. TERESA BLACK M.D.

>> Internal Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1376612507

Individual Registrant:
DR. TERESA  BLACK M.D.
Gender: F
Not Sole Proprietor

Location and contact information for practice:
250 BON AIR RD  GREENBRAE, CA 94904-1702 US
Tel: 415-448-1500  Fax: 415-892-8732

Contact information for business:
300 PROFESSIONAL CENTER DR SUITE 311 NOVATO, CA 94947-4334 US
Tel: 415-448-1555  Fax: 415-892-8732

Registration Information:
NPI: 1376612507
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207R00000XAllopathic & Osteopathic Physicians
Internal Medicine
CAG65715

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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