Provider First Line Business Practice Location Address:
10833 LE CONTE AVE RM A2-383
Provider Second Line Business Practice Location Address:
CHS PEDIATRICS BOX 951752
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90095-1752
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-206-6987
Provider Business Practice Location Address Fax Number:
310-825-0442
Provider Enumeration Date:
12/24/2009