Provider First Line Business Practice Location Address:
2424 CENTRAL AVE
Provider Second Line Business Practice Location Address:
UPSTAIRS
Provider Business Practice Location Address City Name:
ALAMEDA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94501-4516
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-813-8866
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/02/2008