Provider First Line Business Practice Location Address:
2113 E DUDLEY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PASADENA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91104-4122
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-241-3111
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/02/2026