Provider First Line Business Practice Location Address:
1700 E CESAR CHAVEZ AVE
Provider Second Line Business Practice Location Address:
STE 3300
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90033-2424
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-265-4023
Provider Business Practice Location Address Fax Number:
323-265-4053
Provider Enumeration Date:
09/20/2006