Provider First Line Business Practice Location Address:
241 N FIGUEROA ST RM B-9
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:
90012-2601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-250-8616
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/18/2023