Provider First Line Business Practice Location Address:
UCLA UROLOGY 10833 LE CONTE AVE CHS 27-139
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90095-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-825-9945
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/10/2018