Provider First Line Business Practice Location Address:
181 S RANCHO SANTA FE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN MARCOS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92078-2501
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-744-3002
Provider Business Practice Location Address Fax Number:
760-744-3050
Provider Enumeration Date:
03/15/2007