Provider First Line Business Practice Location Address:
7840 FERNWOOD AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CALIFORNIA CITY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93505-2505
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-434-8759
Provider Business Practice Location Address Fax Number:
661-434-8759
Provider Enumeration Date:
07/06/2026