Provider First Line Business Practice Location Address:
2535 TRUXTUN RD
Provider Second Line Business Practice Location Address:
STE. 200
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92106-6160
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-224-5000
Provider Business Practice Location Address Fax Number:
619-224-5008
Provider Enumeration Date:
02/28/2008