Provider First Line Business Practice Location Address:
1260 E OHIO AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ESCONDIDO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92027-3054
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-746-1100
Provider Business Practice Location Address Fax Number:
760-746-1201
Provider Enumeration Date:
06/22/2005