Provider First Line Business Practice Location Address:
1183 E FOOTHILL BLVD
Provider Second Line Business Practice Location Address:
KAISER OUTPATIENT PHARMACY SUITE 134
Provider Business Practice Location Address City Name:
UPLAND
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91786
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
909-367-7080
Provider Business Practice Location Address Fax Number:
909-367-7077
Provider Enumeration Date:
08/05/2021