Provider First Line Business Practice Location Address:
242 EAST 6TH STREET
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:
90014
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-890-7775
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/28/2015