Provider First Line Business Practice Location Address:
44256 N 10TH STREET
Provider Second Line Business Practice Location Address:
MOLINA MEDICAL CENTER
Provider Business Practice Location Address City Name:
W LANCASTER
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93534-4134
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-723-3874
Provider Business Practice Location Address Fax Number:
661-723-9975
Provider Enumeration Date:
06/11/2006