Provider First Line Business Practice Location Address:
1247 S CATALINA ST # E
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:
90006-3305
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-703-5558
Provider Business Practice Location Address Fax Number:
213-365-1206
Provider Enumeration Date:
09/15/2008