Provider First Line Business Practice Location Address:
1430 S. SAN JULIAN ST.
Provider Second Line Business Practice Location Address:
BUILDING #2
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90015-3142
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-765-2830
Provider Business Practice Location Address Fax Number:
213-765-3862
Provider Enumeration Date:
08/16/2007