Provider First Line Business Practice Location Address:
333 S CENTRAL 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:
90013-1724
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-625-5009
Provider Business Practice Location Address Fax Number:
213-625-5025
Provider Enumeration Date:
04/27/2015