Provider First Line Business Practice Location Address:
1901 W 8TH ST
Provider Second Line Business Practice Location Address:
SUITE E
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90057-4900
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-483-8180
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/06/2006