Provider First Line Business Practice Location Address:
6719 ALVARADO RD STE 200
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:
92120-5256
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-229-5018
Provider Business Practice Location Address Fax Number:
619-229-2968
Provider Enumeration Date:
06/26/2008