Provider First Line Business Practice Location Address:
10440 BLACK MOUNTAIN RD
Provider Second Line Business Practice Location Address:
SAN DIEGO MIRAMAR COLLEGE STUDENT HEALTH SERVICES S-103
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92126
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-536-7881
Provider Business Practice Location Address Fax Number:
858-689-0387
Provider Enumeration Date:
10/15/2008