Provider First Line Business Practice Location Address:
1400 W GLENOAKS BOULEVARD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GLENDALE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91201-1911
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-242-1183
Provider Business Practice Location Address Fax Number:
818-246-1085
Provider Enumeration Date:
04/18/2006