Provider First Line Business Practice Location Address:
6317 S FIGUEROA 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:
90003-1025
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-301-8120
Provider Business Practice Location Address Fax Number:
323-544-0890
Provider Enumeration Date:
03/13/2023