Provider First Line Business Practice Location Address:
1011 BALDWIN PARK BLVD.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BALDWIN PARK
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90807
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
626-851-7044
Provider Business Practice Location Address Fax Number:
626-851-7100
Provider Enumeration Date:
06/11/2007