Provider First Line Business Practice Location Address:
433 S NORMANDIE 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:
90020-2906
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-383-0900
Provider Business Practice Location Address Fax Number:
213-383-7085
Provider Enumeration Date:
09/11/2006