Provider First Line Business Practice Location Address:
5893 COPLEY DR FL 4
Provider Second Line Business Practice Location Address:
GENERAL SURGERY
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92111-7906
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-616-5335
Provider Business Practice Location Address Fax Number:
619-516-7179
Provider Enumeration Date:
05/20/2008