Provider First Line Business Practice Location Address:
4938 EL MONTE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TEMPLE CITY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91780
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-888-5819
Provider Business Practice Location Address Fax Number:
626-227-0504
Provider Enumeration Date:
02/05/2026