Provider First Line Business Practice Location Address:
3751 KATELLA AVENUE
Provider Second Line Business Practice Location Address:
LOS ALAMITOS MEDICAL CENTER
Provider Business Practice Location Address City Name:
LOS ALAMITOS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90720
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-779-4972
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/17/2006