Provider First Line Business Practice Location Address:
6244 EL CAJON BLVD
Provider Second Line Business Practice Location Address:
STE 1
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92115-3918
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-583-1100
Provider Business Practice Location Address Fax Number:
619-583-8301
Provider Enumeration Date:
03/06/2007