Provider First Line Business Practice Location Address:
234 CALLE E. CESAR CHAVEZ
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GUADALUPE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93434
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-965-1001
Provider Business Practice Location Address Fax Number:
805-965-2178
Provider Enumeration Date:
07/01/2026