Provider First Line Business Practice Location Address:
727 E GRAND 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:
92025-4404
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-738-7000
Provider Business Practice Location Address Fax Number:
760-738-4213
Provider Enumeration Date:
05/23/2007