Provider First Line Business Practice Location Address:
430 E 2ND 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:
90012-4209
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-617-2228
Provider Business Practice Location Address Fax Number:
213-617-1734
Provider Enumeration Date:
09/26/2006