Provider First Line Business Practice Location Address:
401 N FAIRVIEW AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GOLETA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93117-1732
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-681-1200
Provider Business Practice Location Address Fax Number:
805-692-0857
Provider Enumeration Date:
12/27/2006