Provider First Line Business Practice Location Address:
2015 E. FLORENCE AVE.
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:
90001-2754
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-581-0000
Provider Business Practice Location Address Fax Number:
323-585-4030
Provider Enumeration Date:
06/14/2011