Provider First Line Business Practice Location Address:
730 WELCH RD
Provider Second Line Business Practice Location Address:
PRIMARY CARE CLINIC, FIRST FLOOR
Provider Business Practice Location Address City Name:
PALO ALTO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94304-1503
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
925-964-1793
Provider Business Practice Location Address Fax Number:
925-964-1794
Provider Enumeration Date:
01/04/2007