Provider First Line Business Practice Location Address:
2650 CAMINO DEL RIO N
Provider Second Line Business Practice Location Address:
200
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92108-1621
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-295-3000
Provider Business Practice Location Address Fax Number:
619-295-3011
Provider Enumeration Date:
12/14/2016