Provider First Line Business Practice Location Address:
8352 CLAIREMONT MESA BLVD STE A
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:
92111-1302
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-543-0144
Provider Business Practice Location Address Fax Number:
619-543-0445
Provider Enumeration Date:
04/02/2007