Provider First Line Business Practice Location Address:
1213 S CALIFORNIA AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MONROVIA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91016-4223
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-281-2710
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/14/2025