Provider First Line Business Practice Location Address:
243 MONTEREY RD, UNIT: D
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOUTH PASADENA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91030
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
626-242-5325
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/04/2008