Provider First Line Business Practice Location Address:
2701 FAIRVIEW RD
Provider Second Line Business Practice Location Address:
OCC STUDENT HEALTH SERVICES
Provider Business Practice Location Address City Name:
COSTA MESA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92626-5563
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-432-5026
Provider Business Practice Location Address Fax Number:
714-432-5097
Provider Enumeration Date:
10/15/2007