Provider First Line Business Practice Location Address:
633 N SPRING ST
Provider Second Line Business Practice Location Address:
STE #4
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90012-2814
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-928-0866
Provider Business Practice Location Address Fax Number:
213-928-0868
Provider Enumeration Date:
01/16/2007