Provider First Line Business Practice Location Address:
LBVAMC, 5901 E. SEVENTH STREET
Provider Second Line Business Practice Location Address:
11-111N DIALYSIS UNIT (SOUTH 9TH FLOOR)
Provider Business Practice Location Address City Name:
LONG BEACH
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90822
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-826-5902
Provider Business Practice Location Address Fax Number:
562-826-5037
Provider Enumeration Date:
03/14/2007