Provider First Line Business Practice Location Address:
806 W ADAMS BLVD
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:
90007-2505
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-748-5481
Provider Business Practice Location Address Fax Number:
213-749-1651
Provider Enumeration Date:
02/26/2007