Provider First Line Business Practice Location Address:
31872 COAST HWY
Provider Second Line Business Practice Location Address:
SOUTH COAST MEDICAL CENTER, PATHOLOGY DEPT
Provider Business Practice Location Address City Name:
LAGUNA BEACH
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92651
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
949-499-7181
Provider Business Practice Location Address Fax Number:
949-499-7248
Provider Enumeration Date:
09/20/2006