Provider First Line Business Practice Location Address:
420 E 3RD ST
Provider Second Line Business Practice Location Address:
SUITE 604
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90013-1644
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-626-3330
Provider Business Practice Location Address Fax Number:
213-652-1948
Provider Enumeration Date:
12/10/2008