Provider First Line Business Practice Location Address:
1111 W. 6TH ST.
Provider Second Line Business Practice Location Address:
#120, #102
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90017
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-895-0009
Provider Business Practice Location Address Fax Number:
213-895-0012
Provider Enumeration Date:
03/21/2007