Provider First Line Business Practice Location Address:
1212 PICO ST
Provider Second Line Business Practice Location Address:
SAN FERNANDO HEALTH CENTER
Provider Business Practice Location Address City Name:
SAN FERNANDO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91340
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-837-6969
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/02/2007