Provider First Line Business Practice Location Address:
705 S WOODS AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EAST LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90022-3223
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
626-418-6320
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/02/2024