Provider First Line Business Practice Location Address:
4620 ALVARADO CANYON RD STE 14
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:
92120-4306
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-229-9666
Provider Business Practice Location Address Fax Number:
619-299-9666
Provider Enumeration Date:
01/06/2021