Provider First Line Business Practice Location Address:
1640 W. THIRD 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:
90017
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-483-1251
Provider Business Practice Location Address Fax Number:
213-483-8577
Provider Enumeration Date:
10/05/2005