Provider First Line Business Practice Location Address:
420 PASO ROBLES DR
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:
93108-1062
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-415-2572
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/29/2026