Provider First Line Business Practice Location Address:
1240 N. MISSION RD (INPATIENT TOWER)
Provider Second Line Business Practice Location Address:
3G 100 NSY
Provider Business Practice Location Address City Name:
LA
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:
323-226-3406
Provider Business Practice Location Address Fax Number:
323-226-3440
Provider Enumeration Date:
02/03/2011