Provider First Line Business Practice Location Address:
2200 W 3RD ST STE 390
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:
90057-1932
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-483-5910
Provider Business Practice Location Address Fax Number:
213-483-5913
Provider Enumeration Date:
12/28/2006