Provider First Line Business Practice Location Address:
200 W ARBOR DRIVE
Provider Second Line Business Practice Location Address:
MAIL CODE 8816
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92103-8816
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-543-5570
Provider Business Practice Location Address Fax Number:
619-543-2493
Provider Enumeration Date:
06/06/2007