Provider First Line Business Practice Location Address:
8227 RESEDA BOULEVARD
Provider Second Line Business Practice Location Address:
NORTHRIDGE DIAGNOSTIC CENTER
Provider Business Practice Location Address City Name:
NORTHRIDGE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91335-0000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-773-6500
Provider Business Practice Location Address Fax Number:
818-701-5936
Provider Enumeration Date:
03/29/2007