Provider First Line Business Practice Location Address:
426 S SAN PEDRO 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:
90013-2119
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-626-6411
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/05/2025