Provider First Line Business Practice Location Address:
2211 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:
90057-3120
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-380-7000
Provider Business Practice Location Address Fax Number:
213-387-8330
Provider Enumeration Date:
10/03/2011