Provider First Line Business Practice Location Address:
1945 S LA CIENEGA BLVD
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:
90034-1601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-723-8286
Provider Business Practice Location Address Fax Number:
310-247-4910
Provider Enumeration Date:
06/06/2007