Provider First Line Business Practice Location Address:
711 N ALVARADO ST
Provider Second Line Business Practice Location Address:
112
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90026-4016
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-484-8334
Provider Business Practice Location Address Fax Number:
213-484-8471
Provider Enumeration Date:
12/15/2009