Provider First Line Business Practice Location Address:
3400 W 6TH ST STE 305
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:
90020-2576
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-500-3241
Provider Business Practice Location Address Fax Number:
213-478-0960
Provider Enumeration Date:
10/04/2011