Provider First Line Business Practice Location Address:
5260 S FIGUEROA ST
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90037-3743
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-233-3888
Provider Business Practice Location Address Fax Number:
323-233-3773
Provider Enumeration Date:
04/19/2007