Provider First Line Business Practice Location Address:
DIVISION OF ACUTE CARE SERVICES, LAC-USC MEDICAL CENTER
Provider Second Line Business Practice Location Address:
2051 MARENGO STREET, IPT, C5L100
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90033
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-409-8604
Provider Business Practice Location Address Fax Number:
323-441-9907
Provider Enumeration Date:
01/10/2018