Provider First Line Business Practice Location Address:
4669 MURPHY CANYON RD STE 212
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:
92123-4333
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-569-0056
Provider Business Practice Location Address Fax Number:
858-569-4233
Provider Enumeration Date:
01/19/2018