Provider First Line Business Practice Location Address:
8716 GARFIELD AVE
Provider Second Line Business Practice Location Address:
STE 100
Provider Business Practice Location Address City Name:
SOUTH GATE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90280-3723
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-674-2600
Provider Business Practice Location Address Fax Number:
562-928-9304
Provider Enumeration Date:
08/31/2010