Provider First Line Business Practice Location Address:
8928 S FIGUEROA 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:
90003-3228
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-420-8266
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/19/2025