Provider First Line Business Practice Location Address:
1411 S GARFIELD AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALHAMBRA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91801-5022
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-552-1755
Provider Business Practice Location Address Fax Number:
559-533-1911
Provider Enumeration Date:
07/28/2026