Provider First Line Business Practice Location Address:
313 N FIGUEROA ST
Provider Second Line Business Practice Location Address:
ROOM 212
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90012-2602
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-240-7941
Provider Business Practice Location Address Fax Number:
213-482-4856
Provider Enumeration Date:
02/27/2008