Provider First Line Business Practice Location Address:
3525 DEL MAR HEIGHTS RD
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:
92130-2199
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
888-341-4334
Provider Business Practice Location Address Fax Number:
346-971-4676
Provider Enumeration Date:
03/28/2026