Provider First Line Business Practice Location Address:
10650 BLVD SALINAS
Provider Second Line Business Practice Location Address:
STE 13 PLAZA SALINAS
Provider Business Practice Location Address City Name:
TIJUANA
Provider Business Practice Location Address State Name:
BAJA CALIFORNIA
Provider Business Practice Location Address Postal Code:
22420
Provider Business Practice Location Address Country Code:
MX
Provider Business Practice Location Address Telephone Number:
619-737-2626
Provider Business Practice Location Address Fax Number:
866-272-6924
Provider Enumeration Date:
02/26/2017