Provider First Line Business Practice Location Address:
253 LOBOS ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CARMEL BY THE SEA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93921
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-254-7200
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/24/2026