Provider First Line Business Practice Location Address:
6950 N. PARAMOUNT BLVD
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:
90805
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-531-9711
Provider Business Practice Location Address Fax Number:
562-251-2544
Provider Enumeration Date:
10/02/2009