Provider First Line Business Practice Location Address:
6200 E. SPRING ST., SUITE G
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LONG BEACH
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90815
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-421-7500
Provider Business Practice Location Address Fax Number:
562-421-7511
Provider Enumeration Date:
06/06/2014