Provider First Line Business Practice Location Address:
770 S VERMONT AVE
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:
90005-1520
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-383-2211
Provider Business Practice Location Address Fax Number:
213-674-2458
Provider Enumeration Date:
11/19/2024