Provider First Line Business Practice Location Address:
6005 N FIGUEROA ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HIGHLAND PARK
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90042-4231
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-698-2550
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/23/2024