Provider First Line Business Practice Location Address:
11555 SCRIPPS LAKE DRIVE
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:
92131
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-353-3800
Provider Business Practice Location Address Fax Number:
888-353-3668
Provider Enumeration Date:
10/04/2006