Provider First Line Business Practice Location Address:
1000 W CARSON ST
Provider Second Line Business Practice Location Address:
DEPT. OF PSYCHIATRY, 1-SOUTH
Provider Business Practice Location Address City Name:
TORRANCE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90502-2004
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-222-5267
Provider Business Practice Location Address Fax Number:
310-212-7609
Provider Enumeration Date:
11/01/2006