Provider First Line Business Practice Location Address:
4527 E CESAR CHAVEZ
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:
90022-1116
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-262-9299
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/17/2009