Provider First Line Business Practice Location Address:
3800 WEST CHAPMAN AVENUE
Provider Second Line Business Practice Location Address:
SUITE 7200 - DEPARTMENT OF UROLOGY
Provider Business Practice Location Address City Name:
ORANGE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92868
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
657-263-6189
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/15/2024