Provider First Line Business Practice Location Address:
3712 BAKER ST
Provider Second Line Business Practice Location Address:
KUHMILLO44@GMAIL.COM
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92117
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-834-6753
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/30/2025