Provider First Line Business Practice Location Address:
5155 RUETTE DE MER
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:
92130-2832
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-755-1080
Provider Business Practice Location Address Fax Number:
858-755-6080
Provider Enumeration Date:
10/12/2006