Provider First Line Business Practice Location Address:
1351 MEDICAL CENTER DR STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHULA VISTA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91911-6977
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-305-2200
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/20/2024