Provider First Line Business Practice Location Address:
VA SAN DIEGO HEALTHCARE SYSTEM (116-B)
Provider Second Line Business Practice Location Address:
3350 LA JOLLA VILLAGE DR.
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92161
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-642-3693
Provider Business Practice Location Address Fax Number:
858-552-7414
Provider Enumeration Date:
07/02/2006