Provider First Line Business Practice Location Address:
4339 STATE UNIVERSITY DR
Provider Second Line Business Practice Location Address:
DIAGNOSTIC CENTER OF SOUTHERN CALIFORNIA
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90032-4220
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-222-8090
Provider Business Practice Location Address Fax Number:
323-222-3018
Provider Enumeration Date:
12/27/2005