Provider First Line Business Practice Location Address:
6699 ALVARADO RD STE 2304
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:
92120-5241
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-255-8800
Provider Business Practice Location Address Fax Number:
619-255-8083
Provider Enumeration Date:
06/03/2006