Provider First Line Business Practice Location Address:
1527 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:
90033
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-252-1400
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/18/2021