Provider First Line Business Practice Location Address:
2220 DEL MAR HEIGHTS RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DEL MAR
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92014-3022
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-807-5550
Provider Business Practice Location Address Fax Number:
760-742-2356
Provider Enumeration Date:
06/30/2006