Provider First Line Business Practice Location Address:
3764 CLAIREMONT DRIVE
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:
92117
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-273-7777
Provider Business Practice Location Address Fax Number:
858-273-7790
Provider Enumeration Date:
03/26/2007