Provider First Line Business Practice Location Address:
13434 BARLIN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DOWNEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90242-5106
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-471-8090
Provider Business Practice Location Address Fax Number:
909-397-9745
Provider Enumeration Date:
01/22/2026