Provider First Line Business Practice Location Address:
8220 SOUTH SAN PEDRO ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-541-1221
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/24/2007