Provider First Line Business Practice Location Address:
34800 BOB WILSON DR
Provider Second Line Business Practice Location Address:
DEPT OB/GYN, DIVISION OF MFM
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92134-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-532-7020
Provider Business Practice Location Address Fax Number:
619-532-6378
Provider Enumeration Date:
02/29/2012