Provider First Line Business Practice Location Address:
2260 CALLAGAN HWY BULDG NO 3379
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:
92136-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-310-6769
Provider Business Practice Location Address Fax Number:
619-354-7249
Provider Enumeration Date:
12/01/2020