Provider First Line Business Practice Location Address:
412 TH MEDICAL GROUP SGHC
Provider Second Line Business Practice Location Address:
30 NIGHTINGALE ROAD
Provider Business Practice Location Address City Name:
EDWARDS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93524-1730
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-277-9763
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/26/2007