Provider First Line Business Practice Location Address:
520 SO. LAFAYETTE PK. PL.
Provider Second Line Business Practice Location Address:
3RD FLOOR
Provider Business Practice Location Address City Name:
LA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90057
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-252-2100
Provider Business Practice Location Address Fax Number:
213-383-3146
Provider Enumeration Date:
05/17/2006