Provider First Line Business Practice Location Address:
2300 S. HARBOR BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ANAHEIM
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92802
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-750-3030
Provider Business Practice Location Address Fax Number:
714-971-1708
Provider Enumeration Date:
04/13/2007