Provider First Line Business Practice Location Address:
4022 FIFTH AVENUE
Provider Second Line Business Practice Location Address:
MERCY CLINIC
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92102-8102
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-260-0770
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/18/2007