Provider First Line Business Practice Location Address:
2336 E CESAR E CHAVEZ 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:
90033-1811
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-586-0556
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/03/2021