Provider First Line Business Practice Location Address:
10330 FRIARS RD STE 111
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:
92120-2300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-281-7800
Provider Business Practice Location Address Fax Number:
619-542-1792
Provider Enumeration Date:
12/28/2009