Provider First Line Business Practice Location Address:
3727 W 6TH ST
Provider Second Line Business Practice Location Address:
411
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90020-5105
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-365-7400
Provider Business Practice Location Address Fax Number:
213-201-3993
Provider Enumeration Date:
02/23/2017