Provider First Line Business Practice Location Address:
2417 S. SAN PEDRO 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:
90011-1518
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-749-3934
Provider Business Practice Location Address Fax Number:
213-749-0994
Provider Enumeration Date:
04/07/2025