Provider First Line Business Practice Location Address:
1330 CHAPALA ST UNIT 104A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SANTA BARBARA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93101-3187
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-689-3200
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/15/2025