Provider First Line Business Practice Location Address:
2700 W 3RD ST
Provider Second Line Business Practice Location Address:
SUIT# 110
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90057-1924
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-389-6969
Provider Business Practice Location Address Fax Number:
213-389-7671
Provider Enumeration Date:
12/11/2006