Provider First Line Business Practice Location Address:
100 UCLA MEDICAL PLZ
Provider Second Line Business Practice Location Address:
590
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90024-6970
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-794-7422
Provider Business Practice Location Address Fax Number:
310-208-2158
Provider Enumeration Date:
12/31/2008