Provider First Line Business Practice Location Address:
1225 WILSHIRE 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:
90017
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-977-2280
Provider Business Practice Location Address Fax Number:
213-202-7224
Provider Enumeration Date:
02/27/2008