Provider First Line Business Practice Location Address:
AV SONORA 3637 3 NACOZARI
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TIJUANA
Provider Business Practice Location Address State Name:
BAJA CLIFORNIA
Provider Business Practice Location Address Postal Code:
22020
Provider Business Practice Location Address Country Code:
MX
Provider Business Practice Location Address Telephone Number:
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/14/2026