Provider First Line Business Practice Location Address:
NAVY MEDICAL CLINIC - MARINE CORPS RECRUIT DEPOT
Provider Second Line Business Practice Location Address:
35000 GUADALCANAL ST.
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92140
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-524-4036
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/01/2007