Provider First Line Business Practice Location Address:
16918 DOVE CANYON RD
Provider Second Line Business Practice Location Address:
STE 201
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92127-3501
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-924-1000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/07/2012