Provider First Line Business Practice Location Address:
982 1/2 N EL CENTRO AVE
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:
90038-3014
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
832-247-5070
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/12/2023