Provider First Line Business Practice Location Address:
5809 N FIGUEROA 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:
90042-4227
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-274-1070
Provider Business Practice Location Address Fax Number:
323-982-1575
Provider Enumeration Date:
09/24/2013