Provider First Line Business Practice Location Address:
5150 PLAINVIEW RD
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:
92110-1559
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-336-1246
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/18/2010