Provider First Line Business Practice Location Address:
8704 S DENKER AVE
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:
90047-3423
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-797-7854
Provider Business Practice Location Address Fax Number:
213-449-4554
Provider Enumeration Date:
12/31/2024