Provider First Line Business Practice Location Address:
277 FRANCIS ST
Provider Second Line Business Practice Location Address:
277
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92102-4436
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-755-2830
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/02/2014