Provider First Line Business Practice Location Address:
3003 HEALTH CENTER DR
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:
92123-2700
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-939-4185
Provider Business Practice Location Address Fax Number:
858-939-4972
Provider Enumeration Date:
08/21/2008