Provider First Line Business Practice Location Address:
10243 GENETIC CENTER DR
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:
92121-6310
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-526-6072
Provider Business Practice Location Address Fax Number:
858-526-6071
Provider Enumeration Date:
02/22/2006