Provider First Line Business Practice Location Address:
735 S SOTO ST
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:
90023-1336
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
626-463-1021
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/28/2008