Provider First Line Business Practice Location Address:
1100 S GARFIELD AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALHAMBRA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91801-4713
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
626-281-0501
Provider Business Practice Location Address Fax Number:
626-281-2945
Provider Enumeration Date:
12/14/2006