Provider First Line Business Practice Location Address:
7720 CARDINAL CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92123-3333
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-292-7448
Provider Business Practice Location Address Fax Number:
858-292-0927
Provider Enumeration Date:
07/07/2005