Provider First Line Business Practice Location Address:
603 N. JUNE 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:
90004-1011
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-461-5898
Provider Business Practice Location Address Fax Number:
323-461-5865
Provider Enumeration Date:
07/01/2009