Provider First Line Business Practice Location Address:
34730 BOB WILSON DR STE 201
Provider Second Line Business Practice Location Address:
NMCSD NEUROSCIENCES DEPARTMENT
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92134-3201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-532-7253
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/19/2006