Provider First Line Business Practice Location Address:
150 N BARRINGTON 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:
90049-2921
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-471-0483
Provider Business Practice Location Address Fax Number:
310-476-2833
Provider Enumeration Date:
09/02/2012