Provider First Line Business Practice Location Address:
6119 AGRA ST
Provider Second Line Business Practice Location Address:
BELL GARDENS HIGH SCHOOL MUSD
Provider Business Practice Location Address City Name:
BELL GARDENS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90201-1705
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-887-7900
Provider Business Practice Location Address Fax Number:
562-806-5124
Provider Enumeration Date:
04/24/2007