Provider First Line Business Practice Location Address:
2777 PACIFIC AVE. K 2 1/2
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LONG BEACH
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90806
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-473-0088
Provider Business Practice Location Address Fax Number:
562-473-0080
Provider Enumeration Date:
05/03/2021