Provider First Line Business Practice Location Address:
21000 PLUMMER ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHATSWORTH
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91311-4903
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-882-6400
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/16/2023