Provider First Line Business Practice Location Address:
1933 MONTEREY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOLEDAD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93960-2933
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
831-292-8442
Provider Business Practice Location Address Fax Number:
831-292-8442
Provider Enumeration Date:
04/08/2026