Provider First Line Business Practice Location Address:
2420 W MARTIN LUTHER KING JR BLVD
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:
90008-2727
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-293-4204
Provider Business Practice Location Address Fax Number:
323-293-2851
Provider Enumeration Date:
06/02/2009