Provider First Line Business Practice Location Address:
1725 W 17TH STREET
Provider Second Line Business Practice Location Address:
HEALTH CARE AGENCY
Provider Business Practice Location Address City Name:
SANTA ANA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92706
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-834-8780
Provider Business Practice Location Address Fax Number:
714-834-8275
Provider Enumeration Date:
12/12/2006