Provider First Line Business Practice Location Address:
695 S HARVARD 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:
90005-2501
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-839-4495
Provider Business Practice Location Address Fax Number:
213-365-9454
Provider Enumeration Date:
03/25/2009