Provider First Line Business Practice Location Address:
5944 N FIGUEROA AVE
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:
91791
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-478-8310
Provider Business Practice Location Address Fax Number:
323-478-9561
Provider Enumeration Date:
05/02/2017