Provider First Line Business Practice Location Address:
1812 SAN ANDRES ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SANTA BARBARA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93101-4015
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-515-1427
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/22/2026