Provider First Line Business Practice Location Address:
138 HARVARD AVE
Provider Second Line Business Practice Location Address:
CHAPARRAL MEDICAL GROUP
Provider Business Practice Location Address City Name:
CLAREMONT
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91711-4716
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
909-624-4503
Provider Business Practice Location Address Fax Number:
909-624-6364
Provider Enumeration Date:
04/06/2006