Provider First Line Business Practice Location Address:
5205 AVENIDA ENCINAS
Provider Second Line Business Practice Location Address:
SUITE F
Provider Business Practice Location Address City Name:
CARLSBAD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92008-4366
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-929-8400
Provider Business Practice Location Address Fax Number:
760-931-8708
Provider Enumeration Date:
12/12/2006