Provider First Line Business Practice Location Address:
3902 EL CAJON BLVD STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92105-1016
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
888-992-3240
Provider Business Practice Location Address Fax Number:
888-992-3340
Provider Enumeration Date:
08/15/2022