Provider First Line Business Practice Location Address:
2121 NEWCASTLE AVE.
Provider Second Line Business Practice Location Address:
STE B
Provider Business Practice Location Address City Name:
CARDIFF
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92007
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-207-7223
Provider Business Practice Location Address Fax Number:
760-207-7223
Provider Enumeration Date:
07/14/2006