Provider First Line Business Practice Location Address:
3102 E. HIGHLAND AVENUE
Provider Second Line Business Practice Location Address:
MEDICAL STAFF OFFICE
Provider Business Practice Location Address City Name:
PATTON
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92369
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
909-425-7679
Provider Business Practice Location Address Fax Number:
909-425-6635
Provider Enumeration Date:
04/22/2011