Provider First Line Business Practice Location Address:
90 HIGHLAND AVE
Provider Second Line Business Practice Location Address:
PRIMARY CARE DEPARTMENT
Provider Business Practice Location Address City Name:
SAN MARTIN
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95046-9504
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
408-686-2232
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/04/2006