Provider First Line Business Practice Location Address:
1000 WEST CARSON STREET
Provider Second Line Business Practice Location Address:
HARBOR UCLA MEDICAL CENTER
Provider Business Practice Location Address City Name:
TORRANCE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90509-4720
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-222-3801
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/10/2014