Provider First Line Business Practice Location Address:
3924 W ADAMS 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:
90018-1755
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-998-0654
Provider Business Practice Location Address Fax Number:
323-967-7746
Provider Enumeration Date:
04/10/2020