Provider First Line Business Practice Location Address:
2500 MERCED ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN LEANDRO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94577-4201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-454-1000
Provider Business Practice Location Address Fax Number:
510-732-1357
Provider Enumeration Date:
11/17/2006