Provider First Line Business Practice Location Address:
5151 MURPHY CANYON RD
Provider Second Line Business Practice Location Address:
SUITE 150
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92123-4440
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-275-4522
Provider Business Practice Location Address Fax Number:
619-517-6285
Provider Enumeration Date:
02/09/2016