MEDICARE: DR. LOUISE BLACK-ROBINSON

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	163WC1600X	Continuing Education/Staff Development Registered Nurse	285031	CA

General Provider Information

NPI Number	:	1831981174
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LOUISE BLACK-ROBINSON

Provider Business Mailing Address
First Line	:	PO BOX 10350
Second Line	:
City	:	MORENO VALLEY
State	:	CA
Zip	:	92552-0350
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	PO BOX 10350
Second Line	:
City	:	MORENO VALLEY
State	:	CA
Zip	:	92552-0350
Country	:	US
Telephone Number	:	951-779-1304
Fax Number	:

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

Provider Enumeration Date	:	05/21/2025
Last Update Date	:	05/21/2025

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