Provider First Line Business Practice Location Address:
501 N ORANGE ST
Provider Second Line Business Practice Location Address:
SECOND FLOOR OUTPATIENT PHARMACY
Provider Business Practice Location Address City Name:
GLENDALE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91203-1970
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-550-3540
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/13/2017