Provider First Line Business Practice Location Address:
1200 S INGLEWOOD AVE STE 210
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
INGLEWOOD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90301-8123
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-602-8844
Provider Business Practice Location Address Fax Number:
562-602-8844
Provider Enumeration Date:
03/15/2009