Provider First Line Business Practice Location Address:
5230 CARROLL CANYON RD
Provider Second Line Business Practice Location Address:
#320
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92121
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-220-2525
Provider Business Practice Location Address Fax Number:
858-558-0488
Provider Enumeration Date:
12/04/2006