Provider First Line Business Practice Location Address:
5855 EAST NAPLES PLAZA
Provider Second Line Business Practice Location Address:
SUITE #301
Provider Business Practice Location Address City Name:
LONG BEACH
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90803
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-438-1532
Provider Business Practice Location Address Fax Number:
562-597-3563
Provider Enumeration Date:
08/31/2006