Provider First Line Business Practice Location Address:
4094 4TH AVE., STE. 200, MAIL CODE: 0834
Provider Second Line Business Practice Location Address:
DEPT. OF RADIOLOGY BUSINESS OFFICE, UCSD
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92103
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-543-7636
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/07/2006