Provider First Line Business Practice Location Address:
5151 MURPHY CANYON RD.
Provider Second Line Business Practice Location Address:
SUITE 320
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-206-9684
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/13/2025