Provider First Line Business Practice Location Address:
1000 W 9TH ST
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:
90015-1377
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-489-1282
Provider Business Practice Location Address Fax Number:
213-239-5039
Provider Enumeration Date:
07/02/2005