Provider First Line Business Practice Location Address:
1701 E CESAR CHAVEZ AVENUE
Provider Second Line Business Practice Location Address:
SUITE 560
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90033
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-226-0022
Provider Business Practice Location Address Fax Number:
323-488-9546
Provider Enumeration Date:
06/30/2010