Provider First Line Business Practice Location Address:
16111 PLUMMER STREET,
Provider Second Line Business Practice Location Address:
SEPULVEDA AMBULATORY CARE CENTER
Provider Business Practice Location Address City Name:
SEPULVEDA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91343-2036
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
719-352-1961
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/21/2025