Provider First Line Business Practice Location Address:
16465 SIERRA LAKES PARKWAY
Provider Second Line Business Practice Location Address:
SUITE 250 CHAPARRAL MEDICAL GROUP INC
Provider Business Practice Location Address City Name:
FONTANA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92336-1242
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
909-770-8640
Provider Business Practice Location Address Fax Number:
909-770-8650
Provider Enumeration Date:
01/03/2007