Provider First Line Business Practice Location Address:
975 SERENO DRIVE
Provider Second Line Business Practice Location Address:
KAISER PERMANENTE MEDICAL CENTER
Provider Business Practice Location Address City Name:
VALLEJO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94589-2485
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
707-651-5760
Provider Business Practice Location Address Fax Number:
707-651-2980
Provider Enumeration Date:
01/06/2007