Provider First Line Business Practice Location Address:
2025 CHATSWORTH BLVD
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:
92107-2715
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-224-8286
Provider Business Practice Location Address Fax Number:
619-224-6979
Provider Enumeration Date:
07/26/2006