Provider First Line Business Practice Location Address:
4805 ROSEWOOD 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:
90004-2509
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-469-1000
Provider Business Practice Location Address Fax Number:
323-469-1101
Provider Enumeration Date:
10/04/2006