Provider First Line Business Practice Location Address:
3875 AVOCADO BLVD
Provider Second Line Business Practice Location Address:
PRIMARY CARE 2ND FLOOR
Provider Business Practice Location Address City Name:
LA MESA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91941-7303
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-670-2913
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/02/2008