Provider First Line Business Practice Location Address:
2000 STADIUM WAY
Provider Second Line Business Practice Location Address:
ATTN BARLOW PULMONARY MEDICAL GRP INC
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90026
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-250-4200
Provider Business Practice Location Address Fax Number:
213-250-3274
Provider Enumeration Date:
07/29/2005