Provider First Line Business Practice Location Address:
126 W EL NORTE PKWY
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:
92026-2502
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-741-8986
Provider Business Practice Location Address Fax Number:
760-741-8987
Provider Enumeration Date:
09/06/2006