Provider First Line Business Practice Location Address:
3816 WOODRUFF AVE
Provider Second Line Business Practice Location Address:
STE 302
Provider Business Practice Location Address City Name:
LONG BEACH
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90808-2146
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-429-5300
Provider Business Practice Location Address Fax Number:
562-429-0535
Provider Enumeration Date:
01/05/2007