Provider First Line Business Practice Location Address:
10225 BARNES CANYON RD STE A210
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:
92121-2734
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-577-0027
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/13/2009