Provider First Line Business Practice Location Address:
KAISER PERMANENTE 3420 KENYON ST
Provider Second Line Business Practice Location Address:
2ND FLOOR DEPARTMENT OF PSYCHIATRY
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92110-5001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-221-6170
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/17/2007