Provider First Line Business Practice Location Address:
2222 BANCROFT EXT
Provider Second Line Business Practice Location Address:
UNIVERSITY HEALTH SERVICE- CLINICAL SERVICES
Provider Business Practice Location Address City Name:
BERKELEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94720-4303
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-643-7110
Provider Business Practice Location Address Fax Number:
510-643-9790
Provider Enumeration Date:
09/19/2005