Provider First Line Business Practice Location Address:
7848 PACIFIC BL.
Provider Second Line Business Practice Location Address:
# 10
Provider Business Practice Location Address City Name:
HUNTINGTON PARK
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90255
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-584-8354
Provider Business Practice Location Address Fax Number:
323-584-8349
Provider Enumeration Date:
12/08/2009