Provider First Line Business Practice Location Address:
7819 HEMPHILL 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:
92126-3523
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-349-7820
Provider Business Practice Location Address Fax Number:
858-547-9051
Provider Enumeration Date:
05/01/2009