Provider First Line Business Practice Location Address:
2331 E CESAR CHAVEZ 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:
90033-1810
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-260-7531
Provider Business Practice Location Address Fax Number:
323-261-6782
Provider Enumeration Date:
07/26/2005