Provider First Line Business Practice Location Address:
1575 E FLORENCE AVE STE A
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:
90001-2555
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-537-4121
Provider Business Practice Location Address Fax Number:
323-537-4529
Provider Enumeration Date:
05/01/2007