Provider First Line Business Practice Location Address:
2031 E ORANGETHORPE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLACENTIA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92870-6723
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-279-6001
Provider Business Practice Location Address Fax Number:
714-279-6025
Provider Enumeration Date:
03/29/2007