Provider First Line Business Practice Location Address:
1701 E CESAR E CHAVEZ AVE
Provider Second Line Business Practice Location Address:
STE. 402
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90033-2464
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-317-9200
Provider Business Practice Location Address Fax Number:
323-317-9206
Provider Enumeration Date:
12/06/2010