Provider First Line Business Practice Location Address:
NAVAL MEDICAL CTR
Provider Second Line Business Practice Location Address:
34800 BOB WILSON DR
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92134-5000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-532-9795
Provider Business Practice Location Address Fax Number:
619-532-7508
Provider Enumeration Date:
06/21/2015