Provider First Line Business Practice Location Address:
1001 POTRERO AVENUE
Provider Second Line Business Practice Location Address:
SFGH DEPARTMENT OF RADIOLOGY, ROOM 1X57
Provider Business Practice Location Address City Name:
SAN FRANCISCO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94110-2204
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
415-353-1300
Provider Business Practice Location Address Fax Number:
415-353-8570
Provider Enumeration Date:
06/12/2006