Provider First Line Business Practice Location Address:
809 S HOBART BLVD
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:
90005-2702
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-385-3304
Provider Business Practice Location Address Fax Number:
213-487-2640
Provider Enumeration Date:
04/05/2023