Provider First Line Business Practice Location Address:
10010 CAMPUS POINT DR
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:
92121-1518
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-314-0586
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/22/2006