Provider First Line Business Practice Location Address:
5823 YORK BLVD
Provider Second Line Business Practice Location Address:
1
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90042-2634
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-226-1100
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/25/2008