Provider First Line Business Practice Location Address:
1200 N STATE ST STE 3900
Provider Second Line Business Practice Location Address:
ORTHOPAEDIC DEPT
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90089-1004
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-226-7210
Provider Business Practice Location Address Fax Number:
323-226-4051
Provider Enumeration Date:
04/13/2007