Provider First Line Business Practice Location Address:
PRIV. MIRAMAR 3205
Provider Second Line Business Practice Location Address:
VILLAS DEL PALMAR
Provider Business Practice Location Address City Name:
MEXICALI
Provider Business Practice Location Address State Name:
BAJA CALIFORNIA
Provider Business Practice Location Address Postal Code:
21378
Provider Business Practice Location Address Country Code:
MX
Provider Business Practice Location Address Telephone Number:
686-117-8885
Provider Business Practice Location Address Fax Number:
858-430-3143
Provider Enumeration Date:
04/03/2019