Provider First Line Business Practice Location Address:
2468 JOSE CLEMENTE OROZCO
Provider Second Line Business Practice Location Address:
405
Provider Business Practice Location Address City Name:
TIJUANA
Provider Business Practice Location Address State Name:
BC
Provider Business Practice Location Address Postal Code:
22320
Provider Business Practice Location Address Country Code:
MX
Provider Business Practice Location Address Telephone Number:
619-734-2353
Provider Business Practice Location Address Fax Number:
619-941-1175
Provider Enumeration Date:
05/23/2007