Provider First Line Business Practice Location Address:
3850 VALLEY CENTRE DRIVE
Provider Second Line Business Practice Location Address:
VONS 2119 PHARMACY
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92130
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-793-4667
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/29/2010