Provider First Line Business Practice Location Address:
333 S. TWIN OAKS VALLEY RD
Provider Second Line Business Practice Location Address:
CAL STATE SAN MARCOS SHCS
Provider Business Practice Location Address City Name:
SAN MARCOS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92096-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-750-4920
Provider Business Practice Location Address Fax Number:
760-750-3181
Provider Enumeration Date:
10/03/2006