Provider First Line Business Practice Location Address:
8220 S SAN PEDRO 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:
90003-3030
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-778-0488
Provider Business Practice Location Address Fax Number:
323-778-0485
Provider Enumeration Date:
01/21/2010