Provider First Line Business Practice Location Address:
6166 NANCY RIDGE 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:
92121-3223
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-453-7200
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/29/2006