Provider First Line Business Practice Location Address:
505 E PLAZA DRIVE
Provider Second Line Business Practice Location Address:
CHW MARIAN MEDICAL CENTER
Provider Business Practice Location Address City Name:
SANTA MARIA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93454
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-739-3791
Provider Business Practice Location Address Fax Number:
805-614-2011
Provider Enumeration Date:
05/25/2007