Provider First Line Business Practice Location Address:
150 UCLA MEDICAL PLAZA
Provider Second Line Business Practice Location Address:
RNPH 4-EAST
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-267-7404
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/31/2025