Provider First Line Business Practice Location Address:
240 N VIRGIL AVE
Provider Second Line Business Practice Location Address:
7
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90004-5399
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-426-0555
Provider Business Practice Location Address Fax Number:
213-739-8843
Provider Enumeration Date:
07/10/2010