Provider First Line Business Practice Location Address:
16918 DOVE CANYON RD
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92127-3445
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-924-1000
Provider Business Practice Location Address Fax Number:
858-244-7911
Provider Enumeration Date:
06/25/2009