Provider First Line Business Practice Location Address:
31872 SOUTH COAST HIGHWAY
Provider Second Line Business Practice Location Address:
RADIOLOGY DEPARTMENT
Provider Business Practice Location Address City Name:
LAGUNA BEACH
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92651
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
949-499-7195
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/18/2006