Provider First Line Business Practice Location Address:
200 S WELLS RD
Provider Second Line Business Practice Location Address:
CLINICAS DEL CAMINO REAL INC
Provider Business Practice Location Address City Name:
VENTURA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93004-1302
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-732-9446
Provider Business Practice Location Address Fax Number:
805-647-7163
Provider Enumeration Date:
09/06/2006