Provider First Line Business Practice Location Address:
12036 SCRIPPS HIGHLAND DR STE 100
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:
92131-5155
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-271-4200
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/21/2011