Provider First Line Business Practice Location Address:
3231 E GAGE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUNTINGTON PARK
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90255-5441
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-582-8240
Provider Business Practice Location Address Fax Number:
323-582-8022
Provider Enumeration Date:
03/28/2008