Provider First Line Business Practice Location Address:
1446, 1448 & 1450 DIAMOND ST
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:
92109-3023
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-877-3422
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/24/2021