Provider First Line Business Practice Location Address:
VA GREATER LOS ANGELES HEALTHCARE SYSTEM
Provider Second Line Business Practice Location Address:
11301 WILSHIRE BLVD. BLDG. 213, RM 330 MAILCODE: 10C1
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90073
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-268-4282
Provider Business Practice Location Address Fax Number:
310-268-4128
Provider Enumeration Date:
06/08/2006