Provider First Line Business Practice Location Address:
10549 SCRIPPS POWAY PKWY STE E
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:
92131-3963
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-271-4200
Provider Business Practice Location Address Fax Number:
858-271-5040
Provider Enumeration Date:
02/13/2007