Provider First Line Business Practice Location Address:
1230 COAST VILLAGE CIR STE M
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:
93108-3751
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-316-4111
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/28/2026