Provider First Line Business Practice Location Address:
5601 DE SOTO AVE
Provider Second Line Business Practice Location Address:
THIRD FLOOR--OB/GYN A
Provider Business Practice Location Address City Name:
WOODLAND HILLS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91367-6701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-719-3367
Provider Business Practice Location Address Fax Number:
818-719-2566
Provider Enumeration Date:
01/10/2006