Provider First Line Business Practice Location Address:
PCD SAMPSON (DDG-102)
Provider Second Line Business Practice Location Address:
3975 NORMAN SCOTT RD
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92136
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-556-3578
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/07/2006