Provider First Line Business Practice Location Address:
420 E 3RD STREET
Provider Second Line Business Practice Location Address:
STE 702
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90013-1647
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-626-0561
Provider Business Practice Location Address Fax Number:
213-626-0564
Provider Enumeration Date:
08/29/2006