Provider First Line Business Practice Location Address:
5901 E. 7TH STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LONG BEACH
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90293
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-826-5407
Provider Business Practice Location Address Fax Number:
562-826-8007
Provider Enumeration Date:
10/03/2006