Provider First Line Business Practice Location Address:
1918 UNIVERSITY AVE STE 2A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BERKELEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94704-3263
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-649-1930
Provider Business Practice Location Address Fax Number:
510-649-0627
Provider Enumeration Date:
03/21/2019