Provider First Line Business Practice Location Address:
CLEMENTE OROZCO #1506-203
Provider Second Line Business Practice Location Address:
ZONA URBANA RIO
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:
619-600-5265
Provider Business Practice Location Address Fax Number:
858-430-3143
Provider Enumeration Date:
05/24/2019