Provider First Line Business Practice Location Address:
3045 DE LA VINA ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SANTA BARBARA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93105-3351
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-455-4588
Provider Business Practice Location Address Fax Number:
888-282-6171
Provider Enumeration Date:
04/09/2026