Provider First Line Business Practice Location Address:
6221 METROPOLITAN STREET
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
CARLSBAD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92009
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-707-5090
Provider Business Practice Location Address Fax Number:
760-707-5097
Provider Enumeration Date:
08/26/2005