Provider First Line Business Practice Location Address:
701 W CESAR E CHAVEZ AVE
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90012-2104
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-217-5300
Provider Business Practice Location Address Fax Number:
213-217-5396
Provider Enumeration Date:
03/20/2013