Provider First Line Business Practice Location Address:
3403 E PLAZA BLVD STE H
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NATIONAL CITY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91950-4140
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-267-7796
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/18/2026