Provider First Line Business Practice Location Address:
3914 MURPHY CANYON RD
Provider Second Line Business Practice Location Address:
SUITE A105
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92123-4414
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-277-3142
Provider Business Practice Location Address Fax Number:
858-277-3145
Provider Enumeration Date:
11/22/2010