Provider First Line Business Practice Location Address:
20700 VENTURA BLVD STE 300
Provider Second Line Business Practice Location Address:
KAISER PERMANENTE
Provider Business Practice Location Address City Name:
WOODLAND HILLS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91364-6270
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-592-2435
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/16/2006