Provider First Line Business Practice Location Address:
1608 CENTINELA AVE
Provider Second Line Business Practice Location Address:
7
Provider Business Practice Location Address City Name:
INGLEWOOD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90302
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-216-9600
Provider Business Practice Location Address Fax Number:
310-216-9148
Provider Enumeration Date:
05/24/2007