Provider First Line Business Practice Location Address:
1201 WEST LA VETA AVENUE
Provider Second Line Business Practice Location Address:
CHILDREN'S HOSPITAL OF ORANGE COUNTY
Provider Business Practice Location Address City Name:
ORANGE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92868-3874
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-509-7601
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/27/2013