Provider First Line Business Practice Location Address:
BLDG H100 SANTA MARGERITA RD
Provider Second Line Business Practice Location Address:
NAVAL HOSPITAL CAMP PENDLETON
Provider Business Practice Location Address City Name:
CAMP PENDLETON
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92055-5191
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-725-1200
Provider Business Practice Location Address Fax Number:
760-725-1267
Provider Enumeration Date:
08/01/2008