Provider First Line Business Practice Location Address:
701 S HOEFNER AVE
Provider Second Line Business Practice Location Address:
CDS EASTMONT MUSD
Provider Business Practice Location Address City Name:
MONTEBELLO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90022
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-887-2103
Provider Business Practice Location Address Fax Number:
323-887-2113
Provider Enumeration Date:
04/24/2007