Provider First Line Business Practice Location Address:
3050 ARMSTRONG ST
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:
92111-5702
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-874-6599
Provider Business Practice Location Address Fax Number:
858-467-6729
Provider Enumeration Date:
05/01/2007