Provider First Line Business Practice Location Address:
501 N. CRESCENT WAY
Provider Second Line Business Practice Location Address:
HEALTH SERVICES
Provider Business Practice Location Address City Name:
ANAHEIM
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92803-1716
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-309-7864
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/13/2014