Provider First Line Business Practice Location Address:
3914 MURPHY CANYON RD STE A138
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:
92123-4469
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-948-8063
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/11/2018