Provider First Line Business Practice Location Address:
316 E 2ND ST
Provider Second Line Business Practice Location Address:
SUITE 301
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90012-4221
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-680-9935
Provider Business Practice Location Address Fax Number:
213-620-0010
Provider Enumeration Date:
03/22/2007