Provider First Line Business Practice Location Address:
5550 CARMEL MOUNTAIN RD STE 200
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:
92130-4861
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-630-4000
Provider Business Practice Location Address Fax Number:
619-630-0241
Provider Enumeration Date:
02/02/2017