Provider First Line Business Practice Location Address:
1330 W LAMBERT RD UNIT 133
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LA HABRA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90631-6560
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-587-0231
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/21/2026