Provider First Line Business Practice Location Address:
101 CITRUS AVE
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:
93103-2705
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-315-3032
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/30/2026