Provider First Line Business Practice Location Address:
ENGEMANN HEALTH CTR
Provider Second Line Business Practice Location Address:
1031 W. 34TH STREET, SUITE 450
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90089-3261
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-720-6799
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/15/2016