Provider First Line Business Practice Location Address:
420 E 3RD ST STE 701
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:
90013-1646
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-325-1100
Provider Business Practice Location Address Fax Number:
213-784-1939
Provider Enumeration Date:
01/23/2020