Provider First Line Business Practice Location Address:
6244 EL CAJON BLVD STE 8
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:
92115-3918
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-229-1400
Provider Business Practice Location Address Fax Number:
619-229-1403
Provider Enumeration Date:
04/18/2016