Provider First Line Business Practice Location Address:
8051 IMPERIAL HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DOWNEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90242-3713
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-904-1000
Provider Business Practice Location Address Fax Number:
562-904-0909
Provider Enumeration Date:
07/12/2005