Provider First Line Business Practice Location Address:
2001 S BARRINGTON AVE
Provider Second Line Business Practice Location Address:
STE 215
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90025-5385
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-490-2867
Provider Business Practice Location Address Fax Number:
310-204-1253
Provider Enumeration Date:
07/28/2006