Provider First Line Business Practice Location Address:
7290 NAVAJO RD
Provider Second Line Business Practice Location Address:
SUITE 212
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92119-1629
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-278-0700
Provider Business Practice Location Address Fax Number:
619-278-0707
Provider Enumeration Date:
08/08/2006