Provider First Line Business Practice Location Address:
1750 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:
94612-3408
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-444-1024
Provider Business Practice Location Address Fax Number:
510-444-1025
Provider Enumeration Date:
02/17/2012