Provider First Line Business Practice Location Address:
5250 MURPHY CANYON RD STE 122
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:
92123-4367
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-268-8112
Provider Business Practice Location Address Fax Number:
858-268-4218
Provider Enumeration Date:
07/24/2016