Provider First Line Business Practice Location Address:
7270 CLAIREMONT MESA BLVD
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:
92111-1007
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-215-4485
Provider Business Practice Location Address Fax Number:
858-408-2981
Provider Enumeration Date:
04/19/2023