Provider First Line Business Practice Location Address:
4004 BEYER BLVD
Provider Second Line Business Practice Location Address:
SAN YSIDRO HEALTH CENTER
Provider Business Practice Location Address City Name:
SAN YSIDRO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92173-2007
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-917-7122
Provider Business Practice Location Address Fax Number:
619-474-3722
Provider Enumeration Date:
01/08/2007