Provider First Line Business Practice Location Address:
216 N CATALINA ST
Provider Second Line Business Practice Location Address:
#1
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90004-4740
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-342-7982
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/21/2014