Provider First Line Business Practice Location Address:
1453 W TEMPLE STREET
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:
90026
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-202-3970
Provider Business Practice Location Address Fax Number:
213-975-9257
Provider Enumeration Date:
01/23/2007