Provider First Line Business Practice Location Address:
8300 S VERMONT AVE FL 1
Provider Second Line Business Practice Location Address:
FIRST FLOOR
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90044-3493
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-525-6400
Provider Business Practice Location Address Fax Number:
323-752-8629
Provider Enumeration Date:
09/20/2012