Provider First Line Business Practice Location Address:
3075 HEALTH CENTER DR
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:
92123-2773
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-939-5043
Provider Business Practice Location Address Fax Number:
858-939-5044
Provider Enumeration Date:
03/06/2007