Provider First Line Business Practice Location Address:
5890 EDINGER AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUNTINGTON BEACH
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92649-1705
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-840-2020
Provider Business Practice Location Address Fax Number:
714-840-2025
Provider Enumeration Date:
09/26/2006