Provider First Line Business Practice Location Address:
BUILDING H100 SANTA MARGARITA ROAD
Provider Second Line Business Practice Location Address:
NAVAL HOSPITAL CAMP PENDLTON
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-725-8882
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/12/2013