Provider First Line Business Practice Location Address:
6224 CAMINITO DEL OESTE
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:
92111-6829
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-884-0132
Provider Business Practice Location Address Fax Number:
858-452-3503
Provider Enumeration Date:
01/04/2008