Provider First Line Business Practice Location Address:
9400 RUFFIN CT BLDG B
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:
92123-5300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-874-1082
Provider Business Practice Location Address Fax Number:
858-874-1165
Provider Enumeration Date:
10/24/2012