Provider First Line Business Practice Location Address:
4995 MURPHY CANYON RD STE 204
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:
92123-4365
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-276-8112
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/25/2012