Provider First Line Business Practice Location Address:
AVE 20 DE NOVIEMBRE #12321
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TIJUANA
Provider Business Practice Location Address State Name:
BAJA CALIFORNIA
Provider Business Practice Location Address Postal Code:
22100
Provider Business Practice Location Address Country Code:
MX
Provider Business Practice Location Address Telephone Number:
619-488-3200
Provider Business Practice Location Address Fax Number:
619-164-5718
Provider Enumeration Date:
01/14/2022