Provider First Line Business Practice Location Address:
14445 OLIVE VIEW DRIVE - NORTH ANNEX
Provider Second Line Business Practice Location Address:
OLIVE VIEW-UCLA MEDICAL CENTER
Provider Business Practice Location Address City Name:
SYMAR
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91342
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-364-3107
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/29/2011