Provider First Line Business Practice Location Address:
1220 S MANHATTAN PL
Provider Second Line Business Practice Location Address:
1
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90019-3621
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-737-5989
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/17/2007