Provider First Line Business Practice Location Address:
3934 MURPHY CANYON RD
Provider Second Line Business Practice Location Address:
STE B200
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92123-4437
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-430-9609
Provider Business Practice Location Address Fax Number:
858-326-5083
Provider Enumeration Date:
01/20/2015