Provider First Line Business Practice Location Address:
11428 ARTESIA BLVD STE 3
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ARTESIA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90701-3870
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-653-9347
Provider Business Practice Location Address Fax Number:
562-653-9346
Provider Enumeration Date:
11/08/2006