Provider First Line Business Practice Location Address:
27281 LAS RAMBLAS
Provider Second Line Business Practice Location Address:
COAST RADIOLOGY IMAGING & INTERVENTION, INC, STE200
Provider Business Practice Location Address City Name:
MISSION VIEJO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92691
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
949-212-6526
Provider Business Practice Location Address Fax Number:
949-420-3149
Provider Enumeration Date:
12/17/2007