Provider First Line Business Practice Location Address:
8045 EAST CHAPMAN AVE
Provider Second Line Business Practice Location Address:
BUILDING T - 102 STUDENT HEALTH
Provider Business Practice Location Address City Name:
ORANGE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92869-4773
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-628-4773
Provider Business Practice Location Address Fax Number:
714-628-4749
Provider Enumeration Date:
01/19/2012