Provider First Line Business Practice Location Address:
201 S ALVARADO ST
Provider Second Line Business Practice Location Address:
STE 100
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90057-2320
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-989-1900
Provider Business Practice Location Address Fax Number:
213-989-1923
Provider Enumeration Date:
08/05/2016