Provider First Line Business Practice Location Address:
200 W ARBOR DR
Provider Second Line Business Practice Location Address:
UCSD MEDICAL CENTER, SUITE 8781
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92103-9000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-543-7310
Provider Business Practice Location Address Fax Number:
619-543-7368
Provider Enumeration Date:
09/20/2005