Registry details
Type
Individual
Primary specialty
Dermatology
Enumerated
Jul 14, 2005
License(s)
G70400 (CA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 9025 BALBOA AVE SUITE 105 | San Diego, CA 92123-1520 | 858-571-6800 |
| LOCATION | 9025 BALBOA AVE SUITE 105 | San Diego, CA 92123-1520 | 858-571-6800 |
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