Provider First Line Business Practice Location Address:
2420 W. MLK JR. BLVD
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:
90008
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
424-789-9477
Provider Business Practice Location Address Fax Number:
323-410-0478
Provider Enumeration Date:
03/22/2016