Provider First Line Business Practice Location Address:
OLIVE VIEW-UCLA MEDICAL CENTER
Provider Second Line Business Practice Location Address:
14445 OLIVE VIEW DRIVE HUB CLINIC 4C124
Provider Business Practice Location Address City Name:
SYLMAR
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91342
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
747-210-4680
Provider Business Practice Location Address Fax Number:
747-210-4682
Provider Enumeration Date:
07/11/2006