Provider First Line Business Practice Location Address:
2707 S CENTRAL AVE
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:
90011-5527
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-234-5000
Provider Business Practice Location Address Fax Number:
323-231-3985
Provider Enumeration Date:
04/26/2024