Provider First Line Business Practice Location Address:
7922 ROSECRANS AVE STE P2
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PARAMOUNT
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90723-6028
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-630-5700
Provider Business Practice Location Address Fax Number:
562-630-5705
Provider Enumeration Date:
06/21/2006