Provider First Line Business Practice Location Address:
643 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:
90014-2464
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-629-5169
Provider Business Practice Location Address Fax Number:
213-629-5160
Provider Enumeration Date:
10/07/2015