Provider First Line Business Practice Location Address:
9700 DE SOTO AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHATSWORTH
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91311-4409
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-882-8100
Provider Business Practice Location Address Fax Number:
818-700-8255
Provider Enumeration Date:
10/02/2006