Provider First Line Business Practice Location Address:
6670 ALTON PKWY
Provider Second Line Business Practice Location Address:
MEDICAL OFFICE BUILDING 1
Provider Business Practice Location Address City Name:
IRVINE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92618-3734
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
949-932-5938
Provider Business Practice Location Address Fax Number:
888-648-8775
Provider Enumeration Date:
03/13/2008