Provider First Line Business Practice Location Address:
1120 W WASHINGTON BLVD
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:
90015-3316
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-623-2225
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/10/2006