Provider First Line Business Practice Location Address:
1142 KERN PL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ESCONDIDO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92027-1454
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-533-9943
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/01/2026