Provider First Line Business Practice Location Address:
1343 STRATFORD COURT
Provider Second Line Business Practice Location Address:
DEL MAR PSYCHIATRIC CENTER
Provider Business Practice Location Address City Name:
DEL MAR
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92014
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-523-9409
Provider Business Practice Location Address Fax Number:
858-523-9403
Provider Enumeration Date:
11/22/2006