Provider First Line Business Practice Location Address:
3914 MURPHY CANYON RD STE A152
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:
92123-4465
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-608-1108
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/18/2025