Provider First Line Business Practice Location Address:
1829 SUNSET CLIFFS BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92107-3108
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-223-1601
Provider Business Practice Location Address Fax Number:
619-223-7824
Provider Enumeration Date:
10/13/2006