Provider First Line Business Practice Location Address:
1441 EASTLAKE AVE
Provider Second Line Business Practice Location Address:
USC RADIATION ONCOLOGY NOR G356
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90089-0112
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-865-3072
Provider Business Practice Location Address Fax Number:
323-865-3037
Provider Enumeration Date:
01/11/2007