Provider First Line Business Practice Location Address:
HARBOR-UCLA 1000 W. CARSON STREET
Provider Second Line Business Practice Location Address:
BLDG N25-ROOM E111
Provider Business Practice Location Address City Name:
TORRANCE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90502
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-222-4246
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/04/2007