Provider First Line Business Practice Location Address:
1407 S VERMONT AVE
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:
90006-4503
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-739-0300
Provider Business Practice Location Address Fax Number:
213-739-1300
Provider Enumeration Date:
04/23/2007