Provider First Line Business Practice Location Address:
639 N ESCONDIDO BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ESCONDIDO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92025-1701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-738-1926
Provider Business Practice Location Address Fax Number:
760-738-1928
Provider Enumeration Date:
11/01/2010