Provider First Line Business Practice Location Address:
1701 E CESAR E CHAVEZ AVE STE 125
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:
90033-2445
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-224-2100
Provider Business Practice Location Address Fax Number:
323-224-2106
Provider Enumeration Date:
07/14/2012