Provider First Line Business Practice Location Address:
4305 UNIVERISITY AVENUE SUITE 150
Provider Second Line Business Practice Location Address:
SAN DIEGO FAMILY CARE, DBA MID-CITY COMMUNITY CLINIC-PE
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92105-1601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-280-2058
Provider Business Practice Location Address Fax Number:
858-633-4682
Provider Enumeration Date:
10/16/2007