Provider First Line Business Practice Location Address:
16111 PLUMMER (116A)
Provider Second Line Business Practice Location Address:
PSYCHIATRY DEPARTMENT BLDG 10
Provider Business Practice Location Address City Name:
NORTH HILLS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91343
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-891-7711
Provider Business Practice Location Address Fax Number:
818-223-9277
Provider Enumeration Date:
09/20/2006