Provider First Line Business Practice Location Address:
3890 CRENSHAW BLVD
Provider Second Line Business Practice Location Address:
229
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90008
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-290-9910
Provider Business Practice Location Address Fax Number:
323-290-9911
Provider Enumeration Date:
07/11/2013