Provider First Line Business Practice Location Address:
3706 E CESAR CHAVEZ AVE
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:
90063
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-981-9931
Provider Business Practice Location Address Fax Number:
323-981-9933
Provider Enumeration Date:
01/08/2007