Provider First Line Business Practice Location Address:
701 N ALVARADO ST FL 1
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:
90026-4005
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-277-1451
Provider Business Practice Location Address Fax Number:
213-277-1561
Provider Enumeration Date:
09/10/2024