Provider First Line Business Practice Location Address:
3180 UNIVERSITY AVE
Provider Second Line Business Practice Location Address:
SUITE 400
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92104
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-285-5600
Provider Business Practice Location Address Fax Number:
619-285-5616
Provider Enumeration Date:
02/13/2023