Provider First Line Business Practice Location Address:
1000 W CARSON ST # 498
Provider Second Line Business Practice Location Address:
DMH HARBOR-UCLA OUTPATIENT SERVICES
Provider Business Practice Location Address City Name:
TORRANCE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90502-2004
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-222-1620
Provider Business Practice Location Address Fax Number:
310-328-6822
Provider Enumeration Date:
10/30/2008