Provider First Line Business Practice Location Address:
1225 JAMES M. WOOD 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:
90015-1231
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-387-9097
Provider Business Practice Location Address Fax Number:
213-387-9098
Provider Enumeration Date:
04/16/2007