Provider First Line Business Practice Location Address:
2421 ENCINAL AVE STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALAMEDA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94501-5205
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-865-1996
Provider Business Practice Location Address Fax Number:
510-521-2348
Provider Enumeration Date:
04/09/2007