Provider First Line Business Practice Location Address:
1711 W TEMPLE ST STE 8600
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:
90026-7337
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-413-5935
Provider Business Practice Location Address Fax Number:
213-413-5936
Provider Enumeration Date:
10/17/2006