Provider First Line Business Practice Location Address:
709 N HILL ST
Provider Second Line Business Practice Location Address:
SUITE 23
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90012-2361
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-617-0088
Provider Business Practice Location Address Fax Number:
213-617-2988
Provider Enumeration Date:
04/30/2007