Provider First Line Business Practice Location Address:
DAVID GEFFEN MEDICAL CTR UCLA 10833 LE CONTE AVE
Provider Second Line Business Practice Location Address:
MAILROOM A3-215 CHS, MAILCODE 173216
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90095-1732
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-206-5562
Provider Business Practice Location Address Fax Number:
310-794-4863
Provider Enumeration Date:
10/17/2016