Provider First Line Business Practice Location Address:
1900 E. 4TH STREET
Provider Second Line Business Practice Location Address:
KAISER PERMANENTEPSYCHIATRY DEPT
Provider Business Practice Location Address City Name:
SANTA ANA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92705
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
949-280-8483
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/05/2007