Provider First Line Business Practice Location Address:
10660 WHITE OAK AVE
Provider Second Line Business Practice Location Address:
SUITE 230
Provider Business Practice Location Address City Name:
GRANADA HILLS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91344-5943
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-875-7000
Provider Business Practice Location Address Fax Number:
818-875-5528
Provider Enumeration Date:
04/29/2013