Provider First Line Business Practice Location Address:
2001 S BARRINGTON AVE
Provider Second Line Business Practice Location Address:
SUITE 117
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90025-5337
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-281-7028
Provider Business Practice Location Address Fax Number:
310-204-2864
Provider Enumeration Date:
01/22/2007