Provider First Line Business Practice Location Address:
3000 W 6TH ST STE 204
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:
90020-1564
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-800-1530
Provider Business Practice Location Address Fax Number:
213-263-2848
Provider Enumeration Date:
02/14/2012