Provider First Line Business Practice Location Address:
2051 MARENGO STREET
Provider Second Line Business Practice Location Address:
DEPT OB/GYN INPATIENT TOWER C3 F107
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90033
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-409-8848
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/11/2009