Provider First Line Business Practice Location Address:
555 S BROADWAY
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:
90013-2301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-627-5911
Provider Business Practice Location Address Fax Number:
213-622-8048
Provider Enumeration Date:
11/29/2006