Provider First Line Business Practice Location Address:
2931 W FLORENCE 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:
90043-5110
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-750-8040
Provider Business Practice Location Address Fax Number:
323-750-8075
Provider Enumeration Date:
04/30/2009