Provider First Line Business Practice Location Address:
176 S ALVARADO ST
Provider Second Line Business Practice Location Address:
204
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90057-2218
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-484-1500
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/15/2007