Provider First Line Business Practice Location Address:
1680 E 120-TH STREET
Provider Second Line Business Practice Location Address:
MARTIN LUTHER KING COM HOSPITAL
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90059
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
424-338-8000
Provider Business Practice Location Address Fax Number:
424-338-8962
Provider Enumeration Date:
06/02/2005