Provider First Line Business Practice Location Address:
19600 PLUMMER ST STE 300
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTHRIDGE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91324-2139
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-882-9300
Provider Business Practice Location Address Fax Number:
818-882-9257
Provider Enumeration Date:
12/22/2005