Provider First Line Business Practice Location Address:
4867 SUNSET BOULEVARD
Provider Second Line Business Practice Location Address:
INPATIENT PHARMACY GROUND FLOOR
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90027-5969
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-783-8308
Provider Business Practice Location Address Fax Number:
323-783-4920
Provider Enumeration Date:
11/30/2006