Provider First Line Business Practice Location Address:
1500 SAN PABLO STREET
Provider Second Line Business Practice Location Address:
2ND FLOOR PATHOLOGY LAB
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90033
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-442-9611
Provider Business Practice Location Address Fax Number:
323-442-9993
Provider Enumeration Date:
04/07/2010