Provider First Line Business Mailing Address:
CENTER FOR THE HEALTH SCIENCES ROOM A2 237
Provider Second Line Business Mailing Address:
650 CHARLES E. YOUNG DRIVE SOUTH
Provider Business Mailing Address City Name:
LOS ANGELES
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90095-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-825-2019
Provider Business Mailing Address Fax Number:
310-825-6346