Provider First Line Business Practice Location Address:
309 S VERMONT 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:
90020-1806
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-387-4386
Provider Business Practice Location Address Fax Number:
213-387-4638
Provider Enumeration Date:
01/09/2007