Provider First Line Business Practice Location Address:
BLD 601 MCCAIN BLDG
Provider Second Line Business Practice Location Address:
BRANCH MEDICAL CLINIC NAVAL BASE CORONADO
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92135-7046
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-545-8229
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/22/2009