Provider First Line Business Practice Location Address:
320 W TEMPLE 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:
90012-3208
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-974-0645
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/05/2013