Provider First Line Business Practice Location Address:
3002 ARMSTRONG STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN DIEOG
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92111
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-905-4783
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/12/2022