Provider First Line Business Practice Location Address:
118 MED SURGE # 1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
IRVINE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92697-4375
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
949-824-6211
Provider Business Practice Location Address Fax Number:
949-824-4015
Provider Enumeration Date:
02/08/2007