Provider First Line Business Practice Location Address:
201 S. ALVARADO STREET
Provider Second Line Business Practice Location Address:
SUITE 717
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90057
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-989-6959
Provider Business Practice Location Address Fax Number:
213-989-2012
Provider Enumeration Date:
08/26/2005