MEDICARE: DR. STEVIE BLACK DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	37462	CA

General Provider Information

NPI Number	:	1598614075
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVIE BLACK DC

Provider Business Mailing Address
First Line	:	2216 MONTEZUMA AVE
Second Line	:	.5
City	:	ALHAMBRA
State	:	CA
Zip	:	91803
Country	:	US
Telephone Number	:	509-405-8936
Fax Number	:

Provider Business Practice Location Address
First Line	:	3607 W MAGNOLIA BLVD STE C
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91505-2962
Country	:	US
Telephone Number	:	509-405-8936
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/27/2026
Last Update Date	:	01/27/2026

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Directions to “ DR. STEVIE BLACK DC” Practice Location

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