Provider First Line Business Practice Location Address:
2190 W ADAMS BLVD
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:
90018-2039
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-737-7778
Provider Business Practice Location Address Fax Number:
323-735-7825
Provider Enumeration Date:
10/23/2006