Provider First Line Business Practice Location Address:
16644 W BERNARDO DR
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92127-1901
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
951-273-6200
Provider Business Practice Location Address Fax Number:
858-485-1563
Provider Enumeration Date:
05/02/2007