Provider First Line Business Practice Location Address:
318 N GARFIELD AVE
Provider Second Line Business Practice Location Address:
SUITE A 2ND FL
Provider Business Practice Location Address City Name:
MONTEREY PARK
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91754-1707
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
626-280-2818
Provider Business Practice Location Address Fax Number:
626-280-2848
Provider Enumeration Date:
03/31/2011