Provider First Line Business Practice Location Address:
3663 W 6TH ST STE 301
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:
90020-3050
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-291-3228
Provider Business Practice Location Address Fax Number:
213-596-8848
Provider Enumeration Date:
07/30/2008