Provider First Line Business Practice Location Address:
330 ELLIS ST
Provider Second Line Business Practice Location Address:
GLIDE HEALTH SERVICES, SUITE 518
Provider Business Practice Location Address City Name:
SAN FRANCISCO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94102-2735
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
415-674-6140
Provider Business Practice Location Address Fax Number:
415-885-8512
Provider Enumeration Date:
04/13/2006