Provider First Line Business Practice Location Address:
1428 FRANKLIN 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:
94612-3202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-839-3393
Provider Business Practice Location Address Fax Number:
510-839-4003
Provider Enumeration Date:
05/23/2007