Provider First Line Business Practice Location Address:
C340 MEDICAL SCIENCES I
Provider Second Line Business Practice Location Address:
UC IRVINE DERMATOLOGY
Provider Business Practice Location Address City Name:
IRVINE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92697-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
949-824-5515
Provider Business Practice Location Address Fax Number:
949-824-7454
Provider Enumeration Date:
07/26/2007