Provider First Line Business Practice Location Address:
NHCP, BLDG H100, SANTA MARGARITA RD, ATT: CODE 094
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CAMP PENDLETON
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92055-5191
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-725-1335
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/04/2006