Provider First Line Business Practice Location Address:
116 N ALVARADO 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:
90026-5303
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-413-2111
Provider Business Practice Location Address Fax Number:
213-413-5025
Provider Enumeration Date:
02/14/2007