Provider First Line Business Practice Location Address:
6150 EL CAJON BLVD STE D
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:
92115-3900
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-286-4327
Provider Business Practice Location Address Fax Number:
619-286-4328
Provider Enumeration Date:
07/11/2008