Provider First Line Business Practice Location Address:
10221 S COMPTON AVE
Provider Second Line Business Practice Location Address:
SUITE 203
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-385-5100
Provider Business Practice Location Address Fax Number:
323-566-1638
Provider Enumeration Date:
07/22/2008