Provider First Line Business Practice Location Address:
5998 ALCALA PARK, SERRA HALL 300
Provider Second Line Business Practice Location Address:
UNIVERSITY OF SAN DIEGO WELLNESS SERVICES
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92110-2492
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-260-4655
Provider Business Practice Location Address Fax Number:
619-260-4699
Provider Enumeration Date:
05/04/2006