Provider First Line Business Practice Location Address:
3033 BUNKER HILL DRIVE
Provider Second Line Business Practice Location Address:
KAISER PERMANENTE
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92109
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
773-960-0302
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/27/2006