Provider First Line Business Practice Location Address:
5555 GROSSMONT CENTER DR
Provider Second Line Business Practice Location Address:
RADIOLOGY DEPARTMENT
Provider Business Practice Location Address City Name:
LA MESA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91942-3019
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-841-5200
Provider Business Practice Location Address Fax Number:
508-273-1241
Provider Enumeration Date:
03/29/2010