Provider First Line Business Practice Location Address:
34800 BOB WILSON DRIVE
Provider Second Line Business Practice Location Address:
ATTN: SOCIAL WORK DEPT BLDG 1 / FLOOR 2
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-532-7150
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/28/2007