Provider First Line Business Practice Location Address:
13101 HARTFIELD AVE
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:
92130-1511
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-259-2222
Provider Business Practice Location Address Fax Number:
619-259-2211
Provider Enumeration Date:
10/10/2008