Provider First Line Business Practice Location Address:
8460 S CENTRAL AVE
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:
90001-3761
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-581-7400
Provider Business Practice Location Address Fax Number:
323-581-5500
Provider Enumeration Date:
03/19/2007