Provider First Line Business Practice Location Address:
1666 MEDICAL CENTER DR STE 1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN BERNARDINO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92411-1257
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
909-887-7989
Provider Business Practice Location Address Fax Number:
909-887-7839
Provider Enumeration Date:
11/24/2014