Provider First Line Business Practice Location Address:
1720 W MEDICAL CENTER DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ANAHEIM
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92801-1801
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-535-4850
Provider Business Practice Location Address Fax Number:
714-535-0459
Provider Enumeration Date:
08/20/2009