Provider First Line Business Practice Location Address:
9333 GENESEE AVE
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92121-2111
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-657-8600
Provider Business Practice Location Address Fax Number:
858-657-8625
Provider Enumeration Date:
02/26/2007