Provider First Line Business Practice Location Address:
UCI MEDICAL CENTER, 100 THE CITY DRIVE, SOUTH
Provider Second Line Business Practice Location Address:
BUILDING 56, SUITE 600 ZOT 4490
Provider Business Practice Location Address City Name:
ORANGE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92868-3298
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-456-6933
Provider Business Practice Location Address Fax Number:
714-456-7658
Provider Enumeration Date:
10/23/2006