Provider First Line Business Practice Location Address:
443 S SOTO ST
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:
90033-4315
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-263-6103
Provider Business Practice Location Address Fax Number:
323-263-2004
Provider Enumeration Date:
10/19/2006