Provider First Line Business Practice Location Address:
8444 CRENSHAW BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
INGLEWOOD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90305-1914
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-342-7000
Provider Business Practice Location Address Fax Number:
310-342-7666
Provider Enumeration Date:
08/29/2012