Provider First Line Business Practice Location Address:
1100 GOTTSCHALK MEDICAL PLAZA DRIVE
Provider Second Line Business Practice Location Address:
UNIVERSITY OF CALIFORNIA, IRVINE
Provider Business Practice Location Address City Name:
IRVINE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92697
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
949-824-8726
Provider Business Practice Location Address Fax Number:
949-367-9669
Provider Enumeration Date:
12/31/2007