Provider First Line Business Practice Location Address:
9888 CARMEL MOUNTAIN RD STE J
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92129-2807
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-207-4481
Provider Business Practice Location Address Fax Number:
858-216-8496
Provider Enumeration Date:
10/14/2024