Provider First Line Business Practice Location Address:
201 S. ALVARADO STREET
Provider Second Line Business Practice Location Address:
#602
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90057-2354
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-413-2930
Provider Business Practice Location Address Fax Number:
213-413-7734
Provider Enumeration Date:
06/24/2006