Provider First Line Business Practice Location Address:
BOULEVARD DIAZ ORDAZ #1111-111
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TIJUANA
Provider Business Practice Location Address State Name:
BAJA CALIFORNIA
Provider Business Practice Location Address Postal Code:
22117
Provider Business Practice Location Address Country Code:
MX
Provider Business Practice Location Address Telephone Number:
619-587-9332
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/22/2023