Provider First Line Business Practice Location Address:
730-740 LONG BEACH BLVD
Provider Second Line Business Practice Location Address:
#A & #C
Provider Business Practice Location Address City Name:
LONG BEACH
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90813-4480
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-276-1538
Provider Business Practice Location Address Fax Number:
562-276-1540
Provider Enumeration Date:
01/29/2018