Provider First Line Business Practice Location Address:
4281 W 3RD 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:
90020-3448
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-383-0383
Provider Business Practice Location Address Fax Number:
213-383-3858
Provider Enumeration Date:
01/25/2017