Provider First Line Business Practice Location Address:
2001 RIMBEY AVE
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:
92154-3032
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-420-3620
Provider Business Practice Location Address Fax Number:
619-420-8722
Provider Enumeration Date:
09/29/2008