Provider First Line Business Practice Location Address:
4070 LAUREL CANYON BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STUDIO CITY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91604
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-487-7100
Provider Business Practice Location Address Fax Number:
323-654-9923
Provider Enumeration Date:
02/08/2007