Provider First Line Business Practice Location Address:
3080 E FLORENCE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUNTINGTON PARK
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90255-5828
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-583-8000
Provider Business Practice Location Address Fax Number:
323-582-5567
Provider Enumeration Date:
12/04/2008