Provider First Line Business Practice Location Address:
DAVID GEFFEN SCHOOL OF MEDICINE
Provider Second Line Business Practice Location Address:
BOX 951752
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90095-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-825-9890
Provider Business Practice Location Address Fax Number:
310-825-0442
Provider Enumeration Date:
11/19/2012