Provider First Line Business Practice Location Address:
400 W 30TH 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:
90007-3320
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-284-3200
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/25/2016