Provider First Line Business Practice Location Address:
308 N OXFORD 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:
90004-2710
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-734-7000
Provider Business Practice Location Address Fax Number:
323-467-0994
Provider Enumeration Date:
05/30/2007