Provider First Line Business Practice Location Address:
1333 CHESTNUT AVE ROOM 205
Provider Second Line Business Practice Location Address:
LONG BEACH COMPREHENSIVE HEALTH CENTER
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-599-8636
Provider Business Practice Location Address Fax Number:
562-218-0853
Provider Enumeration Date:
04/29/2008