Provider First Line Business Practice Location Address:
1035 S. VERMONT 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:
90006
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-387-0102
Provider Business Practice Location Address Fax Number:
213-738-8764
Provider Enumeration Date:
04/26/2007