Provider First Line Business Practice Location Address:
15220 AVENIDA RAMBLA
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DESERT HOT SPRINGS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92240-7019
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-984-4767
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/14/2026