Provider First Line Business Practice Location Address:
5701 S HOOVER 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:
90037-4045
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-541-1400
Provider Business Practice Location Address Fax Number:
323-541-1401
Provider Enumeration Date:
02/07/2007