Provider First Line Business Practice Location Address:
1400 S. GRAND AVENUE
Provider Second Line Business Practice Location Address:
SUITE 711
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-741-1406
Provider Business Practice Location Address Fax Number:
213-765-7321
Provider Enumeration Date:
10/03/2006