Provider First Line Business Practice Location Address:
38660 MEDICAL CENTER DR STE A13
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PALMDALE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93551-4385
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
424-234-9329
Provider Business Practice Location Address Fax Number:
866-621-3398
Provider Enumeration Date:
04/15/2025