Provider First Line Business Practice Location Address:
8540 SO SEPULVEDA
Provider Second Line Business Practice Location Address:
PLAZA WEST 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:
90045
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-645-6422
Provider Business Practice Location Address Fax Number:
310-645-9750
Provider Enumeration Date:
05/16/2008