Provider First Line Business Practice Location Address:
100 IRVINE HALL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
IRVINE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92697-4275
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
949-824-7992
Provider Business Practice Location Address Fax Number:
949-824-3135
Provider Enumeration Date:
07/21/2006