Provider First Line Business Practice Location Address:
1001 ARROYO ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN FERNANDO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91340-1817
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-213-0581
Provider Business Practice Location Address Fax Number:
213-213-0580
Provider Enumeration Date:
05/01/2013