Provider First Line Business Practice Location Address:
1339 SAN ELIJO AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CARDIFF
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92007
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-970-3648
Provider Business Practice Location Address Fax Number:
760-436-3664
Provider Enumeration Date:
12/19/2006