Provider First Line Business Practice Location Address:
420 E THIRD ST
Provider Second Line Business Practice Location Address:
SUITE 1002
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90013
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-680-9174
Provider Business Practice Location Address Fax Number:
213-680-4504
Provider Enumeration Date:
05/08/2007