Provider First Line Business Practice Location Address:
5807 M FIGUEROA ST
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:
90042
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-982-0999
Provider Business Practice Location Address Fax Number:
323-982-0333
Provider Enumeration Date:
01/14/2009