Provider First Line Business Practice Location Address:
819 S ALVARADO ST
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90057-4018
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-388-6000
Provider Business Practice Location Address Fax Number:
213-388-0996
Provider Enumeration Date:
08/31/2006