Provider First Line Business Practice Location Address:
2922 DE LA VINA ST
Provider Second Line Business Practice Location Address:
STE C
Provider Business Practice Location Address City Name:
SANTA BARBARA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93105-3372
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-503-0988
Provider Business Practice Location Address Fax Number:
866-246-1018
Provider Enumeration Date:
08/07/2012