Provider First Line Business Practice Location Address:
3060B E 9TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OAKLAND
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94601-2322
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-535-5500
Provider Business Practice Location Address Fax Number:
510-535-4349
Provider Enumeration Date:
08/02/2006