Provider First Line Business Practice Location Address:
2307 W 6TH ST
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:
90057-3119
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-351-2800
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/13/2013