Provider First Line Business Practice Location Address:
2716 S VERMONT AVE
Provider Second Line Business Practice Location Address:
10
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90007-2671
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-399-8575
Provider Business Practice Location Address Fax Number:
213-995-6363
Provider Enumeration Date:
06/15/2010