Provider First Line Business Practice Location Address:
3300 CRAVEN STREET BUILDING 3300
Provider Second Line Business Practice Location Address:
32ND STREET NAVAL STATION BRANCH MEDICAL CLINIC
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92136-5599
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-556-8115
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/15/2006