Provider First Line Business Practice Location Address:
600 S COMMONWEALTH 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:
90005-4001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-639-6411
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/14/2011