Provider First Line Business Practice Location Address:
14300 ALTON PKWY
Provider Second Line Business Practice Location Address:
MEDICAL DEPARTMENT
Provider Business Practice Location Address City Name:
IRVINE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92618-1814
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
949-559-6500
Provider Business Practice Location Address Fax Number:
949-559-6510
Provider Enumeration Date:
12/16/2008