Provider First Line Business Practice Location Address:
800 W 1ST ST #202
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90012-2477
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-617-2344
Provider Business Practice Location Address Fax Number:
213-687-7308
Provider Enumeration Date:
01/23/2007