Provider First Line Business Practice Location Address:
200 UCLS MEDICAL PLAZA, SUITE 135
Provider Second Line Business Practice Location Address:
LEVEL ONE UCLA MEDICAL PLAZA PHARMACY
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90095-6949
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-794-1176
Provider Business Practice Location Address Fax Number:
310-794-1187
Provider Enumeration Date:
05/10/2012