Provider First Line Business Practice Location Address:
200 UCLA MEDICAL PLZ
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90095-9000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-825-7922
Provider Business Practice Location Address Fax Number:
310-267-1899
Provider Enumeration Date:
03/31/2017