Provider First Line Business Practice Location Address:
765 MEDICAL CENTER CT STE 201
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHULA VISTA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91911-6600
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-241-9472
Provider Business Practice Location Address Fax Number:
619-215-0138
Provider Enumeration Date:
09/03/2024