Provider First Line Business Practice Location Address:
527 GARFIELD AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOUTH PASADENA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91030-2210
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-401-2425
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/14/2020