Provider First Line Business Practice Location Address:
6475 ALVARADO ROAD
Provider Second Line Business Practice Location Address:
#120
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92120
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-583-6133
Provider Business Practice Location Address Fax Number:
619-583-0321
Provider Enumeration Date:
10/03/2006