Provider First Line Business Practice Location Address:
3325 SENN RD
Provider Second Line Business Practice Location Address:
NAVAL BASE SAN DIEGO BLDG 291
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92136-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-725-1400
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/29/2006