Provider First Line Business Practice Location Address:
UCLA MEDICAL GROUP
Provider Second Line Business Practice Location Address:
200 MEDICAL PLAZA, B365
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90095-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-743-5203
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/11/2006