Provider First Line Business Practice Location Address:
BLVD AGUA CALIENTE #4558
Provider Second Line Business Practice Location Address:
PISOC C2, CENTRO MEDICO2, CONSULTORIO #10 (CM2-10)
Provider Business Practice Location Address City Name:
TIJUANA
Provider Business Practice Location Address State Name:
BAJA CALIFORNIA
Provider Business Practice Location Address Postal Code:
22014
Provider Business Practice Location Address Country Code:
MX
Provider Business Practice Location Address Telephone Number:
664-971-0125
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/04/2020