Provider First Line Business Practice Location Address:
1300 N VERMONT AVE
Provider Second Line Business Practice Location Address:
#610
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90027
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-665-5600
Provider Business Practice Location Address Fax Number:
323-665-8500
Provider Enumeration Date:
02/15/2006