Provider First Line Business Practice Location Address:
235 N HOOVER 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:
90004-3627
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-382-7252
Provider Business Practice Location Address Fax Number:
213-382-6805
Provider Enumeration Date:
09/29/2005