Provider First Line Business Practice Location Address:
12400 CALIENTE CREEK RD.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CALIENTE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93518
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-867-2301
Provider Business Practice Location Address Fax Number:
661-867-6902
Provider Enumeration Date:
12/09/2025