Provider First Line Business Practice Location Address:
3811 VALLEY CENTRE DR.
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:
92130-3318
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-764-3000
Provider Business Practice Location Address Fax Number:
858-784-5933
Provider Enumeration Date:
12/15/2005