Provider First Line Business Practice Location Address:
1560 CAPALINA CLINIC
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN MARCOS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92069
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-744-2104
Provider Business Practice Location Address Fax Number:
760-744-1382
Provider Enumeration Date:
04/04/2007