Provider First Line Business Practice Location Address:
NBHC MIRAMAR
Provider Second Line Business Practice Location Address:
BLDG 2496 BAUER RD
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92145-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-577-9944
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/11/2009