Provider First Line Business Practice Location Address:
11011 ARBUCKLE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MISSION HILLS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91345-1604
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-279-5900
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/13/2026