Provider First Line Business Practice Location Address:
3142 E PLAZA BLVD STE T
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NATIONAL CITY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91950-3941
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-475-6417
Provider Business Practice Location Address Fax Number:
619-475-6507
Provider Enumeration Date:
06/27/2008