Provider First Line Business Practice Location Address:
43112 15TH ST W
Provider Second Line Business Practice Location Address:
INFUSION PHARMACY ROOM 1434
Provider Business Practice Location Address City Name:
LANCASTER
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93534-6219
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-726-2369
Provider Business Practice Location Address Fax Number:
661-726-2385
Provider Enumeration Date:
10/28/2009