Provider First Line Business Practice Location Address:
101 CITY DRIVE - UCIMC
Provider Second Line Business Practice Location Address:
DIV. OF HUMAN GENETICS; DEPT OF PEDIATRICS; ZOT 4482
Provider Business Practice Location Address City Name:
ORANGE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92868-9286
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-456-5789
Provider Business Practice Location Address Fax Number:
714-456-5330
Provider Enumeration Date:
06/01/2005