Provider First Line Business Practice Location Address:
4650 SUNSET BL., MAIL STOP#115
Provider Second Line Business Practice Location Address:
CHILDRENS HOSPITAL LOS ANGELES ATTN: ANNA HERNANDEZ
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-671-6675
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/13/2007