Provider First Line Business Practice Location Address:
319 N SOTO 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:
90033-1837
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-266-6730
Provider Business Practice Location Address Fax Number:
323-266-6750
Provider Enumeration Date:
03/18/2009