Provider First Line Business Practice Location Address:
1212 S FLOWER ST
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:
90015-2123
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-747-0634
Provider Business Practice Location Address Fax Number:
213-741-9478
Provider Enumeration Date:
08/08/2006