Provider First Line Business Practice Location Address:
200 W. ARBOR DR
Provider Second Line Business Practice Location Address:
8893
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92103-8893
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-543-5540
Provider Business Practice Location Address Fax Number:
619-471-3931
Provider Enumeration Date:
11/28/2007