Provider First Line Business Practice Location Address:
4650 SUNSET BLVD.
Provider Second Line Business Practice Location Address:
NEONATOLOGY, MS #13
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90027-9002
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-361-5939
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/24/2014