Provider First Line Business Practice Location Address:
6645 ALVARADO RD STE 415
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:
92120-5208
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-229-4941
Provider Business Practice Location Address Fax Number:
619-229-4950
Provider Enumeration Date:
07/13/2006