Provider First Line Business Practice Location Address:
1925 W TEMPLE ST
Provider Second Line Business Practice Location Address:
211
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-484-8908
Provider Business Practice Location Address Fax Number:
213-484-8945
Provider Enumeration Date:
10/24/2007