Provider First Line Business Practice Location Address:
4909 MURPHY CANYON RD STE 300
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:
92123-4301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-715-0522
Provider Business Practice Location Address Fax Number:
858-268-9810
Provider Enumeration Date:
07/22/2020