Provider First Line Business Practice Location Address:
2010 ZONAL AVE BLDG LAC
Provider Second Line Business Practice Location Address:
PSYCHIATRY FIRST FLOOR
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90089-0121
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-226-5555
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/05/2012