Provider First Line Business Practice Location Address:
7024 CENTRAL AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEMON GROVE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91945-2112
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
626-975-7250
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/30/2026