Provider First Line Business Practice Location Address:
3800 W CHAPMAN AVENUE
Provider Second Line Business Practice Location Address:
SUITE 7200, UCI DEPARTMENT OF UROLOGY
Provider Business Practice Location Address City Name:
ORANGE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92868-1638
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-456-7005
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/22/2024