Provider First Line Business Practice Location Address:
3710 E CESAR E CHAVEZ AVE STE B
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:
90063-2219
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-263-8000
Provider Business Practice Location Address Fax Number:
323-263-8065
Provider Enumeration Date:
11/08/2006