Provider First Line Business Practice Location Address:
220 E COMPTON BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COMPTON
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90220-2413
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-604-1747
Provider Business Practice Location Address Fax Number:
310-604-0631
Provider Enumeration Date:
12/31/2019