Provider First Line Business Practice Location Address:
360 E 1ST 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:
90012-3902
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-687-8866
Provider Business Practice Location Address Fax Number:
213-687-8086
Provider Enumeration Date:
04/01/2010