Provider First Line Business Practice Location Address:
550 S VERMONT AVE FL 10
Provider Second Line Business Practice Location Address:
OFFICE OF THE MEDICAL DIRECTOR, DEPT OF MENTAL HEALTH
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90020-1912
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-351-6033
Provider Business Practice Location Address Fax Number:
213-738-4646
Provider Enumeration Date:
03/28/2007