Provider First Line Business Practice Location Address:
2001 JUNIPERO SERRA BLVD STE 650
Provider Second Line Business Practice Location Address:
KAISER PERMANENTE SSF, DEPT. OF PSYCHIATRY
Provider Business Practice Location Address City Name:
DALY CITY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94014-3897
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
650-991-6147
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/02/2009