Provider First Line Business Practice Location Address:
5201 RUFFIN RD
Provider Second Line Business Practice Location Address:
BUILDING A
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92123-1653
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-694-3504
Provider Business Practice Location Address Fax Number:
858-694-3987
Provider Enumeration Date:
03/08/2007