Provider First Line Business Practice Location Address:
1463 E PLAZA BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NATIONAL CITY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91950-3613
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-474-6800
Provider Business Practice Location Address Fax Number:
619-474-0623
Provider Enumeration Date:
03/26/2007