Provider First Line Business Practice Location Address:
51 N HIGHLAND AVE
Provider Second Line Business Practice Location Address:
SUITE F
Provider Business Practice Location Address City Name:
NATIONAL CITY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91950-1434
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-264-1114
Provider Business Practice Location Address Fax Number:
619-264-1111
Provider Enumeration Date:
04/01/2008