Provider First Line Business Practice Location Address:
231 E 3RD ST
Provider Second Line Business Practice Location Address:
SUITE G106
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90013-1494
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-473-3030
Provider Business Practice Location Address Fax Number:
213-473-3031
Provider Enumeration Date:
04/05/2007