Provider First Line Business Practice Location Address:
4560 E CESAR E CHAVEZ AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90022-1168
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
626-289-7699
Provider Business Practice Location Address Fax Number:
626-289-4242
Provider Enumeration Date:
09/20/2006