Provider First Line Business Practice Location Address:
6244 EL CAJON BLV
Provider Second Line Business Practice Location Address:
#25
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92115
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-286-6909
Provider Business Practice Location Address Fax Number:
619-286-1199
Provider Enumeration Date:
08/18/2006