Provider First Line Business Practice Location Address:
808 S VERMONT AVE
Provider Second Line Business Practice Location Address:
101
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90005-1584
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-382-5420
Provider Business Practice Location Address Fax Number:
213-382-7404
Provider Enumeration Date:
12/07/2006