Provider First Line Business Practice Location Address:
4524 SAN PEDRO PL
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:
90011-3434
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-231-6000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/19/2020