Provider First Line Business Practice Location Address:
331 W CHANNEL ISLANDS BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PORT HUENEME
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93041-1722
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-204-9941
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/19/2026