Provider First Line Business Practice Location Address:
7451 MISSION GORGE RD
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:
92120-1301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-582-3000
Provider Business Practice Location Address Fax Number:
619-582-3049
Provider Enumeration Date:
05/23/2007