Provider First Line Business Practice Location Address:
2250 3RD AVE
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:
92101-2024
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-230-7585
Provider Business Practice Location Address Fax Number:
858-658-0857
Provider Enumeration Date:
10/21/2013