Provider First Line Business Practice Location Address:
1544 W GLENOAKS BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GLENDALE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91201-1944
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-649-8000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/12/2026