Provider First Line Business Practice Location Address:
1201 1/2 N VERMONT 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:
90029-1703
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-661-2223
Provider Business Practice Location Address Fax Number:
323-661-2224
Provider Enumeration Date:
06/05/2009