Provider First Line Business Practice Location Address:
9353 IMPERIAL HWY
Provider Second Line Business Practice Location Address:
PM & R DEPT, 3RD FLOOR
Provider Business Practice Location Address City Name:
DOWNEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90242-2812
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-657-2718
Provider Business Practice Location Address Fax Number:
562-657-2770
Provider Enumeration Date:
05/14/2007