Provider First Line Business Practice Location Address:
3000 W 6TH ST
Provider Second Line Business Practice Location Address:
2ND FLOOR, STE 211
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90020-1522
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-380-9557
Provider Business Practice Location Address Fax Number:
213-380-9009
Provider Enumeration Date:
10/16/2006