Provider First Line Business Practice Location Address:
911 BROXTON AVENUE
Provider Second Line Business Practice Location Address:
UCLA DIVISION OF GENERAL INTERNAL MEDICINE
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90024-2801
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-794-0150
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/15/2008