Provider First Line Business Practice Location Address:
CALIFORNIA INSTITUTION FOR MEN
Provider Second Line Business Practice Location Address:
14901 CENTRAL AVE.
Provider Business Practice Location Address City Name:
CHINO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91710
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
909-597-1821
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/23/2007