Provider First Line Business Practice Location Address:
3802 CLAIREMONT MESA BLVD
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:
92117-2712
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-273-8300
Provider Business Practice Location Address Fax Number:
858-273-2546
Provider Enumeration Date:
12/21/2006