Provider First Line Business Practice Location Address:
8517 LINDLEY AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTHRIDGE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91325-3737
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-441-1811
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/20/2026