Provider First Line Business Practice Location Address:
1601 CHESTNUT AVE.
Provider Second Line Business Practice Location Address:
SANTA ANA SCHOOL DISTRICT
Provider Business Practice Location Address City Name:
SANTA ANA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92701-6322
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-558-5501
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/26/2007