Provider First Line Business Practice Location Address:
2614 ARTHUR ST STE C
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:
90065-3990
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-250-1300
Provider Business Practice Location Address Fax Number:
213-559-9473
Provider Enumeration Date:
01/14/2009