Provider First Line Business Practice Location Address:
2220 E PLAZA BLVD
Provider Second Line Business Practice Location Address:
STE. H
Provider Business Practice Location Address City Name:
NATIONAL CITY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91950-5161
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-470-2700
Provider Business Practice Location Address Fax Number:
619-236-7822
Provider Enumeration Date:
10/18/2012