Provider First Line Business Practice Location Address:
2200 WEST 3RD STREET
Provider Second Line Business Practice Location Address:
SUITE 400
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90057-1901
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-484-7600
Provider Business Practice Location Address Fax Number:
213-484-7111
Provider Enumeration Date:
10/15/2012