Provider First Line Business Practice Location Address:
2033 W 7TH ST
Provider Second Line Business Practice Location Address:
SUITE 3
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90057-4073
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-484-2288
Provider Business Practice Location Address Fax Number:
213-484-2225
Provider Enumeration Date:
02/15/2007