Provider First Line Business Practice Location Address:
10210 GENETIC CENTER DR
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:
92121-4362
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-410-8086
Provider Business Practice Location Address Fax Number:
858-410-8190
Provider Enumeration Date:
04/06/2007