Provider First Line Business Practice Location Address:
5175 WARING RD
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:
92120-2705
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-583-1000
Provider Business Practice Location Address Fax Number:
619-229-1938
Provider Enumeration Date:
07/12/2006