Provider First Line Business Practice Location Address:
3388 W 8TH ST
Provider Second Line Business Practice Location Address:
#205
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90005-2882
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-368-0073
Provider Business Practice Location Address Fax Number:
213-368-0267
Provider Enumeration Date:
12/19/2006