Provider First Line Business Practice Location Address:
5575 RUFFIN RD
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92123-1380
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-565-1300
Provider Business Practice Location Address Fax Number:
858-565-6932
Provider Enumeration Date:
05/28/2008