Provider First Line Business Practice Location Address:
818 WEBSTER 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:
94607-4220
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-986-6830
Provider Business Practice Location Address Fax Number:
510-986-6890
Provider Enumeration Date:
11/02/2006