Provider First Line Business Practice Location Address:
2228 WEST 7TH STREET
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:
90057
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-383-5773
Provider Business Practice Location Address Fax Number:
213-383-5783
Provider Enumeration Date:
11/01/2006