Provider First Line Business Practice Location Address:
1430 SAN JULIAN ST # 2
Provider Second Line Business Practice Location Address:
LOS ANGELES SCHOOL DISTRICT
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90015-3142
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-765-2821
Provider Business Practice Location Address Fax Number:
213-765-3861
Provider Enumeration Date:
12/28/2005