Provider First Line Business Practice Location Address:
480 S HARBOR BLVD SUITE 7
Provider Second Line Business Practice Location Address:
LAS PALMAS MEDICAL CENTER
Provider Business Practice Location Address City Name:
LA HABRA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90631
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-680-4521
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/08/2008