Provider First Line Business Practice Location Address:
NAVAL MEDICAL CENTER, 34800 BOB WILSON DR.
Provider Second Line Business Practice Location Address:
LAB DEPT EDA. SUITE 305
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92134-1305
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-532-6852
Provider Business Practice Location Address Fax Number:
619-532-9403
Provider Enumeration Date:
01/30/2006