Provider First Line Business Practice Location Address:
2001 S BARRINGTON AVE
Provider Second Line Business Practice Location Address:
#110
Provider Business Practice Location Address City Name:
LA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90025-5337
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-485-1515
Provider Business Practice Location Address Fax Number:
310-477-4688
Provider Enumeration Date:
07/06/2006