Provider First Line Business Practice Location Address:
4647 ZION AVENUE
Provider Second Line Business Practice Location Address:
KAISER PERMANENTE MEDICAL CENTER SAN DIEGO
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92112
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-528-6973
Provider Business Practice Location Address Fax Number:
619-528-3361
Provider Enumeration Date:
01/27/2006