Provider First Line Business Practice Location Address:
EDIFICIO MEDAC #22
Provider Second Line Business Practice Location Address:
SUITE 101-B
Provider Business Practice Location Address City Name:
TIJUANA
Provider Business Practice Location Address State Name:
BAJA CALIFORNIA
Provider Business Practice Location Address Postal Code:
22010
Provider Business Practice Location Address Country Code:
MX
Provider Business Practice Location Address Telephone Number:
619-308-7928
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/16/2025