Provider First Line Business Practice Location Address:
8835 VANS ST
Provider Second Line Business Practice Location Address:
LA PAZ GEROPSYCHIATRIC CENTER
Provider Business Practice Location Address City Name:
PARAMOUNT
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90723-4656
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-633-5111
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/08/2011