Provider First Line Business Practice Location Address:
9815 CARROLL CANYON RD STE 100
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:
92131-1123
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-354-5660
Provider Business Practice Location Address Fax Number:
858-566-7446
Provider Enumeration Date:
12/11/2006