Provider First Line Business Practice Location Address:
2626 N FIGUEROA ST
Provider Second Line Business Practice Location Address:
UNIT C
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90065-1049
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-276-6846
Provider Business Practice Location Address Fax Number:
323-276-6868
Provider Enumeration Date:
12/12/2007