Provider First Line Business Practice Location Address:
4760 S FIGUEROA 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:
90037-3159
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-232-2601
Provider Business Practice Location Address Fax Number:
323-232-1924
Provider Enumeration Date:
05/09/2008