Provider First Line Business Practice Location Address:
2151 W 6TH 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:
90057-3121
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-483-2222
Provider Business Practice Location Address Fax Number:
213-483-6161
Provider Enumeration Date:
04/16/2007