Provider First Line Business Practice Location Address:
2946 W 7TH ST
Provider Second Line Business Practice Location Address:
STE D
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90005-3932
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-385-7078
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/05/2008