Provider First Line Business Practice Location Address:
8899 UNIVERSITY CENTER LN STE 305A
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:
92122-1021
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-453-8899
Provider Business Practice Location Address Fax Number:
858-792-9153
Provider Enumeration Date:
06/30/2006