Provider First Line Business Practice Location Address:
5944 N FIGUEROA ST
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:
90042-4230
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-478-8310
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/13/2017