Provider First Line Business Practice Location Address:
5570 EL CAJON BLVD ST. E
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:
92115
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-582-4466
Provider Business Practice Location Address Fax Number:
619-582-4401
Provider Enumeration Date:
02/13/2007