Provider First Line Business Practice Location Address:
10300 COMPTON 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:
90002-3628
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-357-6600
Provider Business Practice Location Address Fax Number:
323-771-7722
Provider Enumeration Date:
09/17/2006