Provider First Line Business Practice Location Address:
1147 SOUTH ALVARADO STREET
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:
90006
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-381-8531
Provider Business Practice Location Address Fax Number:
213-382-8525
Provider Enumeration Date:
09/23/2008