Provider First Line Business Practice Location Address:
5151 MURPHY CANYON RD STE 150
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:
92123-4480
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-275-4525
Provider Business Practice Location Address Fax Number:
619-275-4526
Provider Enumeration Date:
03/28/2019