Provider First Line Business Practice Location Address:
2618 SOUTH WESTERN AVENUE
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:
90018
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-730-9000
Provider Business Practice Location Address Fax Number:
323-730-4825
Provider Enumeration Date:
05/01/2007