Provider First Line Business Practice Location Address:
1661 PINE STREET
Provider Second Line Business Practice Location Address:
SAN FRANCISCO TOWERS, OUTPATIENT CLINIC
Provider Business Practice Location Address City Name:
SAN FRANCISCO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94109-0401
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
415-447-5571
Provider Business Practice Location Address Fax Number:
415-447-5575
Provider Enumeration Date:
09/27/2005