Provider First Line Business Practice Location Address:
12204 ARTESIA BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ARTESIA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90701-4345
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-860-7999
Provider Business Practice Location Address Fax Number:
562-568-9998
Provider Enumeration Date:
01/15/2009