Provider First Line Business Practice Location Address:
1200 N STATE ST.
Provider Second Line Business Practice Location Address:
DEPT E.R.
Provider Business Practice Location Address City Name:
LA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90023
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-409-6715
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/20/2009