Provider First Line Business Practice Location Address:
2116 ARLINGTON AVE.
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90018
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-388-7806
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/13/2009