Provider First Line Business Practice Location Address:
5350 ALHAMBRA AVE # B
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:
90032-3405
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-276-9141
Provider Business Practice Location Address Fax Number:
323-276-9146
Provider Enumeration Date:
10/18/2007