Provider First Line Business Practice Location Address:
1720 E CESAR E CHAVEZ 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:
90033-2414
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-268-5000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/19/2020