Provider First Line Business Practice Location Address:
8410 SOMERSET BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PARAMOUNT
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90723-3551
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-529-8885
Provider Business Practice Location Address Fax Number:
562-529-8800
Provider Enumeration Date:
11/21/2006