Provider First Line Business Practice Location Address:
679 S HAMPSHIRE
Provider Second Line Business Practice Location Address:
SUITES 310
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90005-1355
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-385-5100
Provider Business Practice Location Address Fax Number:
213-807-1990
Provider Enumeration Date:
03/27/2007