Provider First Line Business Practice Location Address:
420 E 3RD STREET
Provider Second Line Business Practice Location Address:
SUITE 803
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90013-1646
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-617-7073
Provider Business Practice Location Address Fax Number:
213-617-3132
Provider Enumeration Date:
10/02/2006