Provider First Line Business Practice Location Address:
H100 SANTA MARGARITA ROAD, ATTTENTION CODE 094
Provider Second Line Business Practice Location Address:
NAVAL HOSPITAL, CAMP PENDLETON
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:
928-269-3177
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/15/2007