Provider First Line Business Practice Location Address:
2727 CAMINO DEL RIO SOUTH
Provider Second Line Business Practice Location Address:
311
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92108-1665
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-218-1129
Provider Business Practice Location Address Fax Number:
619-265-1873
Provider Enumeration Date:
08/14/2006