Provider First Line Business Practice Location Address:
8220 S SAN PEDRO 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:
90003-3030
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-440-9677
Provider Business Practice Location Address Fax Number:
310-675-5590
Provider Enumeration Date:
09/07/2007