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ESCONDIDO, CALIF. — Makena Medical Center, a 43,000-square-foot medical office building in Escondido, has received a $12.1-million refinance. It is the only medical office building located near the newly constructed Palomar Medical Center. It is also the only authorized off-campus medical office building in the Escondido Research & Technology Center. The seven-year, fixed-rate loan features a 30-year amortization schedule. The funds were used to refinance a bank loan. It was arranged by Nick West of Churchill Mortgage Capital through Guggenheim Commercial Real Estate Finance.