Provider First Line Business Practice Location Address:
1711 WEST TEMPLE ST.
Provider Second Line Business Practice Location Address:
SUITE 7607
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90026
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-381-7370
Provider Business Practice Location Address Fax Number:
213-483-1828
Provider Enumeration Date:
05/08/2008