Provider First Line Business Practice Location Address:
2202 ROSEDALE AVE
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:
94601-4326
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-495-5440
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/26/2009