Provider First Line Business Practice Location Address:
5224 N FIGUEROA STREET
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:
90042-4118
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-259-0456
Provider Business Practice Location Address Fax Number:
323-259-8486
Provider Enumeration Date:
10/20/2006