Provider First Line Business Practice Location Address:
2930 MARTIN LUTHER KING JR WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BERKELEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94703-2151
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-841-1128
Provider Business Practice Location Address Fax Number:
510-841-7920
Provider Enumeration Date:
11/14/2006