Provider First Line Business Practice Location Address:
7283 ENGINEER RD STE D
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:
92111-1414
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-598-5600
Provider Business Practice Location Address Fax Number:
858-598-5619
Provider Enumeration Date:
06/07/2010