Provider First Line Business Practice Location Address:
4455 MURPHY CANYON RD
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92123-4379
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-281-6067
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/01/2012