Provider First Line Business Practice Location Address:
1251 W. REDONDO BEACH BLVD
Provider Second Line Business Practice Location Address:
GARDENA COMMUNITY BASE OUTPATIENT CLINIC
Provider Business Practice Location Address City Name:
GARDENA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90247
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-851-4705
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/19/2006