Provider First Line Business Practice Location Address:
3606 WEST EXPOSITION 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:
90016-4888
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-298-3501
Provider Business Practice Location Address Fax Number:
323-296-3042
Provider Enumeration Date:
02/25/2008