Provider First Line Business Practice Location Address:
325 S LOS ANGELES 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:
90013-1407
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-819-8382
Provider Business Practice Location Address Fax Number:
213-935-8728
Provider Enumeration Date:
08/15/2014