Provider First Line Business Practice Location Address:
500 E VALLEY PKWY
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:
92025-3054
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-737-5110
Provider Business Practice Location Address Fax Number:
760-737-2439
Provider Enumeration Date:
06/19/2013