Provider First Line Business Practice Location Address:
1428 HIGHLAND AVE
Provider Second Line Business Practice Location Address:
OPERATION SAMAHAN
Provider Business Practice Location Address City Name:
NATIONAL CITY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91950-4624
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-477-4450
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/03/2005