Provider First Line Business Practice Location Address:
4551 EL CAJON BLVD
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:
92115-4316
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-280-7185
Provider Business Practice Location Address Fax Number:
657-284-2199
Provider Enumeration Date:
06/25/2021