Provider First Line Business Practice Location Address:
200 WEST ARBOR DRIVE
Provider Second Line Business Practice Location Address:
MC-8384
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92103-8384
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-543-5713
Provider Business Practice Location Address Fax Number:
619-543-7427
Provider Enumeration Date:
01/11/2007