Provider First Line Business Practice Location Address:
202 W LA HABRA BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LA HABRA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90631-5404
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-267-7000
Provider Business Practice Location Address Fax Number:
562-267-1323
Provider Enumeration Date:
09/07/2006