Provider First Line Business Practice Location Address:
350 S BIXEL ST STE 150
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:
90017-1418
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-749-4261
Provider Business Practice Location Address Fax Number:
213-745-1040
Provider Enumeration Date:
03/26/2007