Provider First Line Business Practice Location Address:
16935 WEST BERNARDO DRIVE
Provider Second Line Business Practice Location Address:
108
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92127
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-990-1981
Provider Business Practice Location Address Fax Number:
858-679-8890
Provider Enumeration Date:
07/06/2007