Provider First Line Business Practice Location Address:
34800 BOB WILSON DR
Provider Second Line Business Practice Location Address:
SUITE 308 NEPHROLOGY DIVISION
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92134-5000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-532-8840
Provider Business Practice Location Address Fax Number:
619-532-7178
Provider Enumeration Date:
02/03/2006