Provider First Line Business Practice Location Address:
4880 MARKET ST., VENTURA , CA 93003
Provider Second Line Business Practice Location Address:
4880 MARKET ST., VENTURA , CA 93003
Provider Business Practice Location Address City Name:
SANTA CLARITA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91355-3053
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-666-8293
Provider Business Practice Location Address Fax Number:
818-987-8723
Provider Enumeration Date:
06/30/2026