Provider First Line Business Practice Location Address:
5818 1/2 PRIORY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BELL GARDENS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90201-4847
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-533-6535
Provider Business Practice Location Address Fax Number:
562-533-6535
Provider Enumeration Date:
03/30/2026