Provider First Line Business Practice Location Address:
5920 FRIARS RD
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:
92108-1076
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-684-5700
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/10/2025