Provider First Line Business Practice Location Address:
1676 MEDICAL CENTER DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN BERNARDINO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92411-1213
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
909-887-6481
Provider Business Practice Location Address Fax Number:
909-887-3858
Provider Enumeration Date:
06/09/2005