Provider First Line Business Practice Location Address:
4909 MURPHY CANYON RD STE 110
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:
92123-4300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-478-6856
Provider Business Practice Location Address Fax Number:
800-863-2978
Provider Enumeration Date:
05/03/2007