Provider First Line Business Practice Location Address:
2829 S. GRAND AVE
Provider Second Line Business Practice Location Address:
116
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90007
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-744-3643
Provider Business Practice Location Address Fax Number:
213-744-3594
Provider Enumeration Date:
05/23/2007