Provider First Line Business Practice Location Address:
2200 W THIRD ST
Provider Second Line Business Practice Location Address:
SUITE 400
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90057-1901
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-484-7600
Provider Business Practice Location Address Fax Number:
213-484-7680
Provider Enumeration Date:
09/19/2012