Provider First Line Business Practice Location Address:
10297 SCRIPPS TRAIL
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:
92131-2307
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-586-0443
Provider Business Practice Location Address Fax Number:
858-586-0563
Provider Enumeration Date:
11/08/2006