Provider First Line Business Practice Location Address:
2732 NAVAJO RD STE 202A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EL CAJON
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92020-2149
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-461-1920
Provider Business Practice Location Address Fax Number:
619-461-1919
Provider Enumeration Date:
02/05/2007