Provider First Line Business Practice Location Address:
200 WEST ARBOR DR
Provider Second Line Business Practice Location Address:
UCSD MEDICAL CENTER - DERMATOLOGY - MC 8420
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92103-8420
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-543-3626
Provider Business Practice Location Address Fax Number:
619-741-6655
Provider Enumeration Date:
05/17/2006