Provider First Line Business Practice Location Address:
423 N HOOVER 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:
90004-2306
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-644-2000
Provider Business Practice Location Address Fax Number:
323-953-6588
Provider Enumeration Date:
06/26/2017