Provider First Line Business Practice Location Address:
215 WEST JANSS ROAD
Provider Second Line Business Practice Location Address:
RADIOLOGY DEPARTMENT
Provider Business Practice Location Address City Name:
THOUSAND OAKS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91360
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-497-2727
Provider Business Practice Location Address Fax Number:
805-495-0023
Provider Enumeration Date:
12/22/2005