Provider First Line Business Practice Location Address:
266 S HARVARD BLVD STE 110
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:
90004-4374
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-388-1111
Provider Business Practice Location Address Fax Number:
213-637-4755
Provider Enumeration Date:
06/04/2007