Provider First Line Business Practice Location Address:
757 WESTWOOD PLZ
Provider Second Line Business Practice Location Address:
RR UCLA MEDICAL CENTER, HOUSESTAFF MAILROOM, ROOM B-711
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90095-8358
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-319-4377
Provider Business Practice Location Address Fax Number:
310-319-4425
Provider Enumeration Date:
11/11/2008