Provider First Line Business Practice Location Address:
10670 WEXFORD ST
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:
92131-3940
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-499-2600
Provider Business Practice Location Address Fax Number:
858-621-4018
Provider Enumeration Date:
01/30/2008