Provider First Line Business Practice Location Address:
7045 VAN NUYS BLVD
Provider Second Line Business Practice Location Address:
OLMC UCLA MID VALLEY COMPREHENSIVE HEALTH CENTER
Provider Business Practice Location Address City Name:
VAN NUYS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91405
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-947-4000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/27/2006