Provider First Line Business Practice Location Address:
NAVAL HOSPITAL, CAMP PENDLETON BLDG H100
Provider Second Line Business Practice Location Address:
ATTENTION: CODE 094
Provider Business Practice Location Address City Name:
CAMP PENDLETON
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92055-5191
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-496-8050
Provider Business Practice Location Address Fax Number:
210-496-8970
Provider Enumeration Date:
02/25/2008