Provider First Line Business Practice Location Address:
274 ONE AND HALF S RAMPART BLVD
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:
90057
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-368-1113
Provider Business Practice Location Address Fax Number:
213-368-1313
Provider Enumeration Date:
03/13/2008