Provider First Line Business Practice Location Address:
7601 IMPERIAL HWAY
Provider Second Line Business Practice Location Address:
RANCHO LOS MIGOS NATIONAL REHABILITATION CENTER
Provider Business Practice Location Address City Name:
DOWNEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90242
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-401-7611
Provider Business Practice Location Address Fax Number:
562-401-7615
Provider Enumeration Date:
06/28/2007