Provider First Line Business Practice Location Address:
303 N RECORD AVE
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:
90063
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-268-2144
Provider Business Practice Location Address Fax Number:
323-544-1442
Provider Enumeration Date:
03/05/2013