Provider First Line Business Practice Location Address:
4740 MURPHY CANYON ROAD SUITE # 205
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:
92123
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-697-1111
Provider Business Practice Location Address Fax Number:
858-750-3441
Provider Enumeration Date:
06/25/2015