Provider First Line Business Practice Location Address:
3444 KEARNY VILLA RD STE 202
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:
92123-1960
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-810-7200
Provider Business Practice Location Address Fax Number:
858-500-8021
Provider Enumeration Date:
02/11/2011