Provider First Line Business Practice Location Address:
1 MEDICAL PLAZA DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
IRVINE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92697-2498
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
949-824-0606
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/02/2006