Provider First Line Business Practice Location Address:
13580 OSBORNE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ARLETA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91331-5524
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-213-0581
Provider Business Practice Location Address Fax Number:
213-213-0580
Provider Enumeration Date:
02/15/2008