Provider First Line Business Practice Location Address:
2403 E CESAR E CHAVEZ AVE
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:
90033-3001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-269-7329
Provider Business Practice Location Address Fax Number:
323-269-6802
Provider Enumeration Date:
08/31/2006