Provider First Line Business Practice Location Address:
8300 W 3RD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90048-4311
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-653-3344
Provider Business Practice Location Address Fax Number:
323-653-5853
Provider Enumeration Date:
03/13/2007