Provider First Line Business Practice Location Address:
PASEO DEL CENTERNARIO #9580-2205A
Provider Second Line Business Practice Location Address:
NEW CITY MEDICAL PLAZA
Provider Business Practice Location Address City Name:
TIJUANA
Provider Business Practice Location Address State Name:
BAJA CALIF
Provider Business Practice Location Address Postal Code:
22010
Provider Business Practice Location Address Country Code:
MX
Provider Business Practice Location Address Telephone Number:
664-685-8014
Provider Business Practice Location Address Fax Number:
866-864-5572
Provider Enumeration Date:
05/19/2022