Provider First Line Business Practice Location Address:
150 NORTH RENO ST.
Provider Second Line Business Practice Location Address:
QUEENSCARE HEALTH CENTER
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90026
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-380-7298
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/11/2013