Provider First Line Business Practice Location Address:
425 S. BROADWAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90013
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-213-0100
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/01/2016